Stage IIB Positive in Two Nodes Treatment Questions
I am hoping to get feedback from others on treatment decisions for someone in my situation. Diagnosed at 51 years old, I am stage 2B, with two positive axillary nodes. I had left mastectomy with axillary node dissection four weeks ago. Post surgical pathology shows left breast invasive carcinoma with mixed ductal and lobular features (2.6 cm tumor) along with ductal carcinoma in situ, and intermediate and metastatic carcinoma in two of five lymph nodes examined. Two positive nodes showed macrometastasis and extranodal extension present. Overall tumor grade was 2. I am ER/PR positive, HER2 negative, post menopausal, and I don't have genetic markers for breast cancer but have had some family history of it.
Initially I was told I would have chemo, radiation (to nodes only) and endocrine therapy. Now there is a question about whether chemo is beneficial and whether radiation even to nodes is wise due to my auto immune condition, Scleroderma. I am waiting Oncotype results and have set up a second opinion appointment. I do not want to go through chemo but I wonder if I bypass chemo and can't have the radiation due to the auto immune condition what risk does that put me at with recurrence down the road since cancer was in two nodes? What choices have others made? From what I have read, ER/PR positive, HER2 negative early diagnosis patients do well first five years. However, it appears recurrence in years 6-15 is a concern. The RXPonder study (taking into account OncoType score) from what I can tell, is looking at statistics for first five years and then estimates the rest of the years.
Any feedback on what decisions others have made as far as skipping chemo and radiation based solely on Oncotype score would be appreciated.