Should I do chemo?

If you have time to wait for your oncotype score, I would wait.  If not, you have to weigh the tx plan against the possible longterm side effects. What drugs are they proposing? Do you have any pre-exposure to possible carginogenic triggers like benzene?  Is your heart is good shape...could it stand some deterioration from the drugs? Research the drugs and compare the possible se's to your history.

For me, the question wasn't should I take chemo to get the extra 4%...it was what can I do to get 1% here, 2% there on top of it...I would take/do anything that gave me a slight edge. Chemo was a given.

I felt pretty good about my physcial state before I started chemo. I'm about 1/3 of the way through and the most significant physical change/side effect is the loss of hair. Of course, the long term se's are an unknown as yet, but if they do develop I will take the intervening years as a gift of the TAC, not that it robbed me, for without the chemo, I surely would NOT have them.

I was a stage one grade three with tumor of 1.5 cm.  I was er/pr positive her2 negative.  No lymph nodes and clean margins on the lumpectomy.  I opted out of the chemo and did the radiation and taking the femara.  My onco dx score was an 18.  I am not sorry I did not do the chemo as the side effects of that were enough to make me think long and hard.  My doctors are keeping a close eye on me and if it were to come back then hopefully it would be caught in time to do something then.  I know several people who were similar to mine and did the chemo and it still came back with in a few years so I researched and all and decided no to the chemo.

Hi, you and I have almost the exact diagnosis! I will hopefully know my oncotype score by Friday.When are you expecting yours? I am not sure if the SE's of chemo are worth possibly reducing the risk of recurrance by under 5%. I am 42, premenopausal, so that is also a factor. I am calling my onc tomorrrow to see if the results came in. Quite honestly, I'm more afraid of the chemo. than anything else. Keep in touch, and let us know how you're doing.

Good luck and god bless

Kim

Theresag, wait for your Oncotype results.  That will give you one more bit of information to factor into your decision.

These days, it is really hard for an oncologist to predict the risk of recurrence for a node-negative, Stage I tumor that is ER+ and HER2 neg.  The grade is certainly important, but the Oncotype score will provide a clearer indication of the aggressiveness of the tumor than you have so far.

My Oncotype score was 26, which was higher than I expected it would be, considering how long my lump had been there without an increase in size.  That Oncotype score corresponds to a risk of recurrence = 17%.  My onco said chemo would reduce that risk by 1/3, giving me a risk of recurrence of around 12%.  For me, that was enough to warrant chemo...but just barely.

Maybe your Oncotype score will be really low, and you won't have to worry.

otter 

Kim/lilwebb,

No, you're not crazy if you opt out of chemo.  It is so tough to have these choices to make!  OTOH, I don't know if we would be much happier, if our docs made all the choices for us.  That's one reason why I fired my first onco--he didn't want to discuss anything with me.  He just said when the time was right, he would give me his recommendation.

As I mentioned, my Oncotype score was 26, and chemo doesn't give me much improvement in my risk of recurrence.  At least, it's not the improvement I would have liked.  Five percent is even slightly less.  Gosh, I just don't know what to suggest.  My mental cutoff for chemo/no chemo was a score of around 25, but that was probably plus or minus a few points if I was going to be honest.

Some women go all-out and fight for that last 1 or 2% of risk reduction, but I wouldn't have done that.  Chemo itself has risks, like heart damage and leukemia and neuropathy. The risk of those long-term complications is low, but it can be a few percentage points. The "discomfort" of the immediate SE's of chemo did not discourage me.  Those really are "do-able"; it's the long-term, possibly permanent damage that I was worried about.

OTOH, a BC recurrence sure can be a permanent problem.  Try the what-if game:  How would you feel if your coin-flip ended up "no chemo"?  Then, what if it came up "chemo"?  Which makes you more comfortable (or uncomfortable)?  Sometimes that's the only way I can make decisions.

otter (feeling your pain!) 

My score was 17 and one of the many doctors I talked to was a woman from University of Michigan hospital.  She said if it were her, she would definitely do chemo.

Wednesday I wasn't feeling very good from my last treatment, but I forced myself to go to Curves.  I ran into an old neighbor and because I was wearing a scarf it wasn't hard to figure things out so I told her what was going on.  I had no idea, but she told me she got breast cancer at age 26 with a 5 month old baby and a 3 year old.  She went through chemo, was sick a lot, but is glad she did it.  Her mother got breast cancer and died from it.  Her sister got it twice and elected not to go through chemo the first time; the second time she had no choice.  My neighbor's doctor told her at her last visit, it was very fortunately that she was treated so aggressively, because he's sure that is why she is a 30 yr. Breast Cancer Survivor.  That gave me what I needed  to realize I am doing the right thing.

It's a not easy and some days I want to quit, but I won't and my family won't let me.  I look forward to when I get back to normal a few days after my treatment and I'm going  that time right now.  I'm 1/3 of the way through and looking forward to the end.  Good luck on your decision and God Bless, Mary