treatment options

Yes, I had a small lump removed without any further treatment. There has been no further treatment because I refused to allow it. It was about 1cm in size and consisted of 60% grade 1 IDC mixed with 40% grade 1 DCIS in a single tumor. I was diagnosed about a week after my 49th B-day in 2/2004 and I had a lumpectomy with SNB in 3/2004. Had I not refused further treatment, I would have recieved radiation after the lumpectomy and now be taking either tamoxifen or arimidex. I'm still doing well after 4 years with no recurrence.

Tell your mom not to worry too much at this point about the prospect of possibly needing chemo. There will be much more information available for consideration after the surgery is done and the surgical pathology report is available. At her age, there's a good possibility that the tumor is a lower grade and that her SNB will be negative. If so, she won't even need chemo with such a small tumor.

There are a number of factors that are considered in the treatment decision, including the size of the tumor, the grade and hormone status of the tumor (indicating aggressiveness), lymph node status, the size of the margins, and yes, the age of the patient. 

If your mother's final pathology is a 0.5cm lump with no lymph node involvement, if the surgeon gets wide margins (i.e. the breast tissue that is removed has the lump pretty much in the middle with about 1cm of breast tissue with no cancer at the edges), and if the tumor is not overly aggressive, then it is very possible that no further treatment will be necessary.  Certainly chemo would not be required with that type of pathology.  Radiation might be recommended, but if the margins are wide enough, as MarieKelly indicated, this could be considered optional. 

On the other hand, someone who has a 0.5cm tumor that is very aggressive (HER2+, for example) might be put on chemo.  If there is lymph node involvement, chemo and/or radiation might be recommended.  And even for a less aggressive tumor, if the margins are very narrow, radiation will be recommended.  Hopefully your mother's tumor fits into the first description, not any of these situations. 

My mother was in her early 80s when she was diagnosed.  Her tumor was about 0.5cm.  The surgeon didn't achieve sufficient margins after the first surgery so a re-excision was done.  The margins after this second surgery were nice and wide.  Although radiation was discussed, all my mother's doctors agreed that the benefit would be very small and it would be quite safe to go on with no further treatment.  That was 3+ years ago and she's been fine ever since.

I actually have 3 small incisions. My lumpectomy incision is the largest and it's about 1 and 1/2 inches -  it's now barely visible. If I stood naked in front of you, you probably wouldn't even notice it unless you got up very close and I pointed it out to you.  I also have another incision at the biopsy site (close to the main incision) that's about a half inch long - can barely see that one now too. My surgeon removed the biopsy track when he did the lumpectomy, so that's the reason for that one. The third incision is about an inch or so and it's the sentinel node biopsy incison under my left arm.

The total size of the tissue that was removed from me with the lumpectomy was 7.5 x 5.5 x 3 cm - a large amount for a 1 cm tumor, but the reason for the 7.5 cm is because the biopsy track came out along with the tumor. It sounds like a huge amount of tissue, but I have large breasts so it made very little difference. Cosmetically, I couldn't have hoped for better results. The affected breast is about a cup size smaller (now only a DD!), but it always was a little smaller than the other one anyway and otherwise still has a perfectly normal appearing shape that matches the other one. 

I actually have 3 small incisions. My lumpectomy incision is the largest and it's about 1 and 1/2 inches -  it's now barely visible. If I stood naked in front of you, you probably wouldn't even notice it unless you got up very close and I pointed it out to you.  I also have another incision at the biopsy site (close to the main incision) that's about a half inch long - can barely see that one now too. My surgeon removed the biopsy track when he did the lumpectomy, so that's the reason for that one. The third incision is about an inch or so and it's the sentinel node biopsy incison under my left arm.

The total size of the tissue that was removed from me with the lumpectomy was 7.5 x 5.5 x 3 cm - a large amount for a 1 cm tumor, but the reason for the 7.5 cm is because the biopsy track came out along with the tumor. It sounds like a huge amount of tissue, but I have large breasts so it made very little difference. Cosmetically, I couldn't have hoped for better results. The affected breast is about a cup size smaller (now only a DD!), but it always was a little smaller than the other one anyway and otherwise still has a perfectly normal appearing shape that matches the other one. 

I actually have 3 small incisions. My lumpectomy incision is the largest and it's about 1 and 1/2 inches -  it's now barely visible. If I stood naked in front of you, you probably wouldn't even notice it unless you got up very close and I pointed it out to you.  I also have another incision at the biopsy site (close to the main incision) that's about a half inch long - can barely see that one now too. My surgeon removed the biopsy track when he did the lumpectomy, so that's the reason for that one. The third incision is about an inch or so and it's the sentinel node biopsy incison under my left arm.

The total size of the tissue that was removed from me with the lumpectomy was 7.5 x 5.5 x 3 cm - a large amount for a 1 cm tumor, but the reason for the 7.5 cm is because the biopsy track came out along with the tumor. It sounds like a huge amount of tissue, but I have large breasts so it made very little difference. Cosmetically, I couldn't have hoped for better results. The affected breast is about a cup size smaller (now only a DD!), but it always was a little smaller than the other one anyway and otherwise still has a perfectly normal appearing shape that matches the other one. 

I actually have 3 small incisions. My lumpectomy incision is the largest and it's about 1 and 1/2 inches -  it's now barely visible. If I stood naked in front of you, you probably wouldn't even notice it unless you got up very close and I pointed it out to you.  I also have another incision at the biopsy site (close to the main incision) that's about a half inch long - can barely see that one now too. My surgeon removed the biopsy track when he did the lumpectomy, so that's the reason for that one. The third incision is about an inch or so and it's the sentinel node biopsy incison under my left arm.

The total size of the tissue that was removed from me with the lumpectomy was 7.5 x 5.5 x 3 cm - a large amount for a 1 cm tumor, but the reason for the 7.5 cm is because the biopsy track came out along with the tumor. It sounds like a huge amount of tissue, but I have large breasts so it made very little difference. Cosmetically, I couldn't have hoped for better results. The affected breast is about a cup size smaller (now only a DD!), but it always was a little smaller than the other one anyway and otherwise still has a perfectly normal appearing shape that matches the other one. 

I actually have 3 small incisions. My lumpectomy incision is the largest and it's about 1 and 1/2 inches -  it's now barely visible. If I stood naked in front of you, you probably wouldn't even notice it unless you got up very close and I pointed it out to you.  I also have another incision at the biopsy site (close to the main incision) that's about a half inch long - can barely see that one now too. My surgeon removed the biopsy track when he did the lumpectomy, so that's the reason for that one. The third incision is about an inch or so and it's the sentinel node biopsy incison under my left arm.

The total size of the tissue that was removed from me with the lumpectomy was 7.5 x 5.5 x 3 cm - a large amount for a 1 cm tumor, but the reason for the 7.5 cm is because the biopsy track came out along with the tumor. It sounds like a huge amount of tissue, but I have large breasts so it made very little difference. Cosmetically, I couldn't have hoped for better results. The affected breast is about a cup size smaller (now only a DD!), but it always was a little smaller than the other one anyway and otherwise still has a perfectly normal appearing shape that matches the other one. 

I actually have 3 small incisions. My lumpectomy incision is the largest and it's about 1 and 1/2 inches -  it's now barely visible. If I stood naked in front of you, you probably wouldn't even notice it unless you got up very close and I pointed it out to you.  I also have another incision at the biopsy site (close to the main incision) that's about a half inch long - can barely see that one now too. My surgeon removed the biopsy track when he did the lumpectomy, so that's the reason for that one. The third incision is about an inch or so and it's the sentinel node biopsy incison under my left arm.

The total size of the tissue that was removed from me with the lumpectomy was 7.5 x 5.5 x 3 cm - a large amount for a 1 cm tumor, but the reason for the 7.5 cm is because the biopsy track came out along with the tumor. It sounds like a huge amount of tissue, but I have large breasts so it made very little difference. Cosmetically, I couldn't have hoped for better results. The affected breast is about a cup size smaller (now only a DD!), but it always was a little smaller than the other one anyway and otherwise still has a perfectly normal appearing shape that matches the other one. 

Please excuse all the deleted duplicates. My computer seemed to have a bad case of the hiccups for a few minutes there. Don't know what happened.