HI! New here :)

Hi, Tanya, and welcome. Sorry you had to join us, but it's a great group of ladies here.

 One comment I want to stress is that with the lumpectomy, your local recurrence rate without radiation is something like 40%, even with clean margins. If you don't opt for a mastectomy, it is very, very important that you radiate the lumpectomy site. I don't think there are very many docs who would let you go w/o the rads.

As far as chemo goes, it's a tough decision, because all your prognostic factors are excellent except for your age. Have they ordered Oncotype DX for you? Sometimes that score can help with the decision process, although most women seem to fall in the intermediate score area, which doesn't help with the chemo decision much.

I assume they've plugged the chemo and hormone treatment decisions into Adjuvent Online for you?

 How big was your tumor? Some oncs say anything over 1 cm automatically buys you chemo, even with negative nodes.

I chose to do chemo, rads, tamoxifen. I was 38 at diagnosis this June, and had a 2.7 cm tumor of an aggressive subtype, and a very strong family history of cancer, including my mom with Stage IV bc. So those were my bad prognostic factors. My good ones were oncotype of 18, hormone positive, HER negative, no nodes. So I was right in the middle of good/bad. I talked to 3 docs, and each one recommended chemo. Two recommended ACx4, one recommended TACx6. Big difference between the two as far as toxicity. I chose FACx6, which is a compromise between the two.

 I thought long and hard about just doing hormones, especially because I have lobular cancer, which is some studies have shown to be chemo resistent. However, given how many decades I have to live still in theory, I wasn't comfortable not doing chemo. I have two young children, and if I do have distant recurrence in the future, I want to feel like it was inevitable, not that I should have done chemo. My mom did chemo the first time around, and progressed anyhow, but her cancer is very aggressive, HER+. Sometimes it doesn't matter what you do, the cancer is stronger. She's been on chemo for 5 years now.

It's a really, really hard decision. I wouldn't be comfortable doing nothing. In your case, I think most docs would say rads and tamoxifen at the bare minimum. 

 Hope this helps a little bit. Hopefully some more gals will be along soon to chime in. Good luck with everything!

My two cents-- you can't do nothing.

I think that option is just opening you up to get breast cancer in the future.  And, you're right-- it's all about your age.

With such a small tumor and clear margins, presuming you are ER positive, you should definitely take Tamoxifen.

If you wanted to be more radical I'd go for rads and tamox, but b/c your tumor was so tiny, radiation might do more damage then good.  You should meet with a radiation oncologist to determine this.

You have to think about your future risk for cancer in the same or other breast. 1-2% per calendar yr of your life. 

If I were you, I would jump on the five yr tamox. badwagon ASAP.

You sound really well versed, and I'm glad youre getting second and third opinions. Also, as far as your surgeon that tells you to do nothing, Um-- he should stick to cutting and sewing, and leave fighting the cancer to the oncologists. Just my opinion.

I was dx at age 26, and chose to do the most aggressive treatment possible, b/c of my tumor characterisitics, and being very high risk for recurrence. 

Three years later, I am happily about to turn 30, and cancer free-- living a great life.  As I know you will too!!

Hi Tanya,

I must say that you sound like you are on top of things.  Please listen to the girls and err on the side of caution.  I had a very very aggressive cancer and was in chemo so long...I had to remind myself what life was like without chemo.  You will get through this.  You seem really strong and its a good thing that you are getting the hang of the "lingo" it helps you understand the doctors explanations.  It appears from your notes that you have a fairly non-aggressive form.  I will add you to my list of prayers and feel free to im me if you have any questions or just need a shoulder...tashagraves@yahoo.com