Need Advice Please
Hi I'm new here.... I was diagnosed this pass July with Stage 2 grade 2 (ER/PR+ • HER2-) breast cancer and had a double mastectomy in August. My largest tumor was almost an inch (22mm)...... My oncotype dx score came back as a 12...so my oncologist said no chemo. Going into surgery they thought my lymph nodes were clear but found one with Micrometastasis in it... they ended up removing six all together (5 were clear & 1 had the Micrometastasis)... two different oncologist at Vanderbilt told me I don't need radiation for the one node because most oncologist don't count Micrometastasis. They see it as a node negative. They also said that typically, radiation after mastectomy is only recommended for larger tumors (>5 cm) or multiple positive lymph nodes (usually 4 or more). I'm so confused & scared. Has anyone else had this and didn't need radiation or chemo?
I appreciate all the advice!
Comments
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Penguin - that is correct that rads are not usually done after a BMX. Chemo is a possibility, but you need to give us more information. What is your hormone status? Her2 status? What was the tumor size?
I was ER/PR negative so no other treatment, but my surgery was for DCIS - NOT IDC. I had a local recurrence micromet to a lymph node by my collar bone 2 years after my mastectomy. At that point it had morphed into HER2+, so chemo was a given. Along with node dissection surgery.
Vanderbuilt is a good university and National Comprehensive Cancer center. I was at Baylor, also an NCI cancer center. Still, I went outside their system for a second opinion.
Hopefully Beesie will come along with some of her charts about Stage 2 Grade 2 and the size. Good luck.
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Welcome, Penguin93! We're so sorry you find yourself here, but we hope you find the support and advice you need. Our knowledgeable members are here to offer guidance!
The Mods
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Thank you for responding... my diagnosis was stage 2 grade 2 Er/Pr + HER2-
They told me no chemo because of my oncotype score (12). They said chemo would not benefit me. My largest tumor was almost an inch (22mm)... I had 6 lymph nodes removed with one containing micro.
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Penguin, I was in almost the exact same situation as you, except I had 2 sentinel nodes and one had micromets. I also had an Oncotype of 12 and a tumor that was 25 mm. I went to 3 different radiation oncologists and all 3 did not recommend radiation. My tumor was on the left and they said the risk outweighed the benefit. I am on hormonal therapy and will be for 10 years.
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Penguin - generally speaking, a node with micromets is considered to be negative. And you would generally not be recommended radiation with a BMX and negative nodes unless your primary tumor were large, and/or margins were positive. Radiation is no fun and has lasting consequences. If an RO had told me I didn't need it I would have bolted from the office before they could change their mind.
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Thank you for responding 💗...I just wanted to make sure I’m doing everything possible. I appreciate you all taking the time to respond!
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ditto hapa! Be very grateful radiation not recommended. All of these treatments are toxic. I am 2 weeks into radiation and my breast has swollen 2 cup sizes and my skin is already cracking and turning pink. There are long term changes to breast tissue and skin. This kills healthy tissue as well as cancer cells. I actually wanted to do a BMX to avoid rads, but my BS talked me out of it.
take care and good luck, but it sounds like your team is doing the standard of care for you. I am also stage II but had lumpectomy hence rads. OncoType 11, MO said chemo won't even work on my particular tumor because I have a low mitotic rate, chemo targets cells with high mitotic rate. So on to Hormonal therapy. It sounds like you are in a very similar situation. It sounds like you are on a good track.
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