Deciding whether to do chemo

cy19

Hi all,

I’m new to this forum- have spent some time reading other posts but this is my first. I was diagnosed with ILC on 2/7 and had a single mastectomy (left) on 3/7. Met with MO 4/6. Surgery pathology revealed 1.5 cm tumor plus one other .2 cm mass. Sentinel node #1 had some isolated cancer cells but considered node negative for all four nodes. Oncotype score 17 with recurrence percentage of 5%. MO is open to chemo but tests suggest less than 1% benefit. I am trying to decide what to do next and would any appreciate any advice or feedback.

Luckynumber47

From what you’ve written my first reaction is no chemo. Isn’t there a graph on the back of your oncotype report that shows benefit vs damage of chemo? Mine showed a negative benefit with stats very similar to yours.

Some other factors that might play into your decision - your age, grade and stage of the cancer. Are you pre or post menopausal, will you be taking tamoxifen or an AI? Do you know you KI67. I’m assuming you are Her2- but are your hormone numbers good and high?

jrnj

also wondering how old you are. I had similar stats and wanted to do it. But I also had 2 affected nodes 2 mm and 3 mm, lvi, extra nodal extension and pleomorphic features. I had drs say no chemo but I went for 3 opinions. Sloan said yes. Also note oncotype was not conclusive for node positive 2 years ago and the benefit conclusion assumes you will take endocrine therapy. No one told me endocrine can be worse than chemo and could be lifelong. But I did CMF an older less toxic chemo.

cy19

thanks for your responses. I am 47. ER/PR pos, HER2 neg. Cancer stage 1A, tumor grade 2. Premenopausal, will be taking tamoxifen.

Luckynumber47

Those stats all look grea and current research points to no chemo. Save the chemo in case this sneaky little cancer tries to come back. Mine was IDC, 1.5cm, ITC, focal lvi, stage 1a, grade 2, oncotype 18. Chemo was never even suggested

cheftoast

cy19 I had a similar diagnosis and oncotype (ILC, oncotype 16) and the MO said chemo would have little benefit to balance out the side effects. I am in no way a doctor, but I also read a bunch of studies that suggest ILC in general is not as responsive to chemo as other breast cancers. The endocrine meds are really important for ILC, which sucks, but here we are.

I'm 25% through radiation after an oncoplastic breast reduction in mid-February. Done with rads end of April, probably start tamoxifen mid-May. Dreading it but ILC is a stealthy jerk, so gonna buckle down and hope for the best. With ILC you will have aggressive imagining, possibly as much as twice a year, to look for any changes. My PS told me from now on it'll all be diagnostic imaging too, not screening, which is what we had before cancer. Hope that helps.