Topic: IDC, Stage I, Grade I, 1.8cm, her2/neg, ER+/PR+

Hi Otter,

My onco is fairly new. He just started practicing maybe a year or two.  My surgeon recommended him.  The onco says my oncotype dc recurrence score is on the borderline and that my tumor was 1.8 cm.  He said he would not recommend chemo if my recurrence score was 11 or below and if my tumor was 1.3 cm or less.  I am definitely going to get a second opinion.  The onco said the same as you that if I get chemo it would lessen about 2 percent of recurrence.  I already made two other appts to see 2 other onco's. 

Thank you so much.

Nikkiannej 

I was under the impression that onco score of 17 or less was a no-brainer for no chemo.

I agree, 2nd opinion.

My onc said the current rate of thinking is that if chemo offers 4% or less benefit, to try and skip it.  I had ILC but yours is a grade 1....and I had a score of 20.

Hi Wallycat,

Yes, I am definitely going for a 2nd and a 3rd opinion.  I think my onco is a new kid on the block.  He is 48 years old.  

Thank you,

Nikkiannej

My diagnosis was similar (grade 1 IDC) with the exceptions that the tumor was smaller at just under 1.0 , 40% of it was grade 1 DCIS and I was 49 at diagnosis and already in menopause. I never had the Oncotype testing. Chemo wasn't even recommended but I would have refused it for this type of cancer even if it had been. The only treatment I had was a lumpectomy and SNB. I refused radiation and I also refused hormonal therapy. It's over 4 years now and I've had no recurrence of that cancer. Definately seek as many opinions as possible to get the best prospective on what treatment is an absolute necessity and what can be safely declined. The odds are greatly in your favor in support of that particular cancer having been completely cured by just surgical excision.

Hmmmm. This is making me wonder.  I have a similar diagnosis: IDC, grade 1, stage 1, ER/PR+ HER2-, but multifocal (1.3 and 1.4cm). No oncotype testing.  I'm on AC.  I'm 33 and was told that due to my age there would be no question that I would be given all available treatments.  I also chose a bi-lat.  I went extreme, but this is what I wanted to do.

D.

Howdy everyone! My first visit here. I had lumpectomy w/clear margins and  snb = neg  2 weeks ago. IDC Stage 1, Grade 1, .7cm, her2/-, ER+/PR+. Next week I consult w/ medical onco, the follow week w/ radiation onco. Surgeon said 6 weeks radiation and hormone blocker. I am almost 50 and postmenopausal w/ fibromyalgia. Very concerned about effects on fibro from radiation and hormone blockers. Any info would be greatly appreciated. I don't want a fibro flare-up from treatment for bc and not be able to stay on treatment schedule. My goal is finish treatment by 50th birthday in July.

Thank you and God Bless,

kimbly, the AdjuvantOnline website address is:

http://www.AdjuvantOnline.com.

Yes, it is supposed to be restricted to health professionals, and I can honestly claim that title (although I am not an M.D.).  I had no trouble registering and logging in under my professional name and address.  I've heard other people were able to sort of "sneak in," althought the site discourages non-physicians from accessing the information.  I guess they're worried we would not know what to do with it.

otter 

I was diagnosed in May 2006 with IDC. Had lumpectomy, 4 cycles of chemo, 33 rads treatements, and now Arimidex for at least 5 years.  My tumor was 1.3 cm and I was grade 3, my Oncotype was 15.  Both oncs recommended chemo.  Then my case was presented at the hospital's breast cancer board which was attended by oncologists, pathologists, radiologists and surgeons. The recommendation was the same. 

As much as I dreaded going for chemo, I felt it was the right thing to do for me because I wanted to make sure that everything was done to eradicate the cancer cells (never can be 100% sure but I didn't want to take any chances). I had chemo in June 2006 and it was tough but it was doable and I think I would make the same decision if I had to go back again. 

In addition to the medical info, it comes down to a personal decision.  You just have to be careful - on this site and with your doctors - because often people are trying to push their own agenda (not from the people who responded to you thus far).  What you'll find in this world of cancer is that the answers are sometimes murky and the physicians will often turn to us - the least informed/educated - to make the final decision.

By the way, having a new onco may not be a bad thing - what they lack in experience is made up by the fact that they usually have the most recent and state of the art knowledge about cancer treatment.

Hi girls,

Oops, I am going for my 3rd opinion today, 04-28-06 at 3:30 p.m. and will be going for my 4th opinion on 05-07-08, Wednesday.

Nikki

Nikki, it's good to hear that you might not need chemo after all!  I was hoping that was the case.  Now, I hope your other consulting docs don't disagree and and make things more confusing.

If your oncologist did not make it clear that you should start taking the Tamoxifen now, or wait awhile, you should call to check on that.  Sometimes there are good reasons to delay treatments, and I don't know if that applies to Tamoxifen with radiation therapy.

otter 

Hi Girls ,

Today I went for my 3rd opinion,  the onco recommends me chemo treatment because of the size of my tumor which is 1.8 cm and that I am 43 yrs old and that I can handle it.  This onco said getting chemo treatment will bring down the recurrence of the cancer by 5%, down 2% more than radiation and hormone therapy.??????????

(I don't think I understood her)

Today I didn't tell the onco that I was planning to get treatment from her.  Anyway she took samples of my blood to be set to the the lab which I forgot to ask her why.  The onco is sending me to the radiology to get a whole body bone spec and wants me to get a CT scan of the chest and abd/pelvis.  She says I will be getting chemo treatment (4 times) and will be getting TC which is Taxotex & Cytoxan every 3 weeks.   After chemo, I will be getting radiation treatment 5 times a week for 5/6 weeks and will be on hormone therapy tamoxifen. 

My first onco recommends chemo treatment.  My second onco recommends me NO chemo and my third onco recommends me chemo, so that is 1 no chemo and 2 chemo.  I will be seeing another onco next Wednesday, May 7th for my 4th and final opinion.  I should be able to make up my mind to do chemo or not. 

Thank you for all your help and your comments. 

Nikki

I know there are many voices to hear and listen or not to.  My choice after having Stage 1, grade 2, 1.7cm IDC/DCIS and another 1 cm ILC/LCIS was to do chemo and hormones.  The choice of course was mine, and my onco was 11 which was low, but I'm in a trial and was randomized to do the chemo.  I could have opted out of the chemo, but b/c of the combined sizes (which measured 2.7 cm) and the grade 2 and the type being both and other factors, we did opt for the chemo.  I do wish we had done TC rather than A/C, but thats hind sight before I learned more on this site and other of the side effects of Adriamycin.

It's a personal decision and one not easily made.  You must be totally at peace with your decision after educating yourself on everything you can.  Only then can you go on to treatment and follow your heart and mind.  I wish you all that, peace and knowledge!

We'll be here too, to help you through as chemo and rads are doable as all will tell you. Good Luck and prayers in your decision and tx!

Nikki,

I was diagnosed at 43 also, 3 years ago this month. My oncologist is also young and suggested chemo too. My tumor 1.5cm, er and pr+, grade 2, her2-, no lymph node involvement, Stage I, pretty close to what yours is. My surgeon suggested I take the Oncotype DX test. He said the only reason they had suggested chemo was because I was premenopausal and any tumor over 1cm, they suggest chemo. My Oncotype DX score was 12. 92% chance cancer would not come back. Chemo would have brought it up only 3%, to 95%. I decided then and there that I would not have chemo.

I had 6 weeks of radiation and I decided to have a total hysterectomy (ovaries,everything) after my radiation, to get rid of those estrogen ovaries (I already have 4 kids) and awful heavy periods. 2 weeks post surgery I started on Arimidex. I switched to Femara after a year, because of all the joint pain. About 9 months later I switched back to Arimidex, because my feet killed me so much on Femara, I had a hard time walking. I have about a month left on Arimidex, and then I'm trying Tamoxifen. If my pains do not get better, I'm getting off everything. I've a couple of breaks from all of the meds, and the pain, hot flashes, etc. all go away. I'm just sick of feeling 90!

Good luck in you decision!

Lynne