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Why chemo?

ruby216 Member Posts: 22

Hi! I'm pretty new around here. I am in the midst of the thumb-twiddling days of waiting for my MRI and genetic testing results to come in prior to my 2/9/23 surgery date. I'm definitely having a mastectomy of my left breast. I might end up going for DMX. Still not sure. Here's my question. If I end up having no lymph node involvement, and I have a DMX, why do I have to have chemo? Is it possible I won't need it? (I have triple positive IDC) I didn't think to ask my oncologist this question, and today is Sunday, so I don't think she'll get back to me today if I message her. Thanks for any insight you wise ones may be able to share!


  • kaynotrealname
    kaynotrealname Member Posts: 346

    One of the problems with breast cancer is the way it spreads. It's not just through the lymph nodes. It can also spread through the blood stream from the tumor itself as it sheds tiny little cells that go all over the place and years later one to two or more can decide to start growing and then you have metastatic breast cancer which has no cure currently. For tumors that are faster growing, chemo can be a great help in preventing this possibility from materializing. And with a triple positive tumor your's is automatically going to be designated as faster growing thanks to HER. So yes, they are going to want to give you chemo automatically regardless of lymph node status unless your tumor is tiny. But, you will also qualify for herceptin or something equivalent and that has been a game changer in treatment making triple positives tumors arguably ones with the best prognosis now. So unfortunately your treatment will be tough but you will also have an excellent chance of never hearing the word breast cancer again when it all ends.

  • elainetherese
    elainetherese Member Posts: 1,625

    Yep, if you're triple positive, you'll be riding the chemo train. Triple positive is definitely a marathon -- I had the works -- chemo then surgery then radiation + targeted therapy (Herceptin for a year) and, of course, hormonal therapy (I'm finishing year eight of the ten-year plan).

    Breast cancer is not always a localized disease. For many, surgery may be enough. For others, and those of us with aggressive variants, chemo is necessary to prevent cancer cells from setting up shop in our bones, lungs, liver, and brain (and HER2+ cancer has a tendency to go to the brain). Chemo lasted five months. It sucked, but I'm glad I did it. Good luck!

  • ruby216
    ruby216 Member Posts: 22

    Thanks so much for this helpful explanation. I'm happy to understand this now and get on with my Sunday rather than obsessing until tomorrow when I can talk to my doctor.

  • ruby216
    ruby216 Member Posts: 22

    Thanks for your reply Elainetherese! Sounds like HER+ is a good news-bad news feature of my diagnosis. Sounds like I just need to buckle up and prepare for the ride ahead. Thanks for sharing your experience. It really helps.

  • mountainmia
    mountainmia Member Posts: 857

    "Almost all women with HER2-positive cancers still need some amount of chemotherapy. " You might find this article interesting and helpful:

  • melbo
    melbo Member Posts: 266

    HER2 is definitely good news/bad news, but with the treatment options it’s mostly good news. Yes it’s faster growing and requires chemo, which sucks a lot, but with herceptin and Perjeta and other treatment options it almost always responds well to treatment.

    I recommend finding a chemo thread and reading through it to get an idea of what to expect. It’s going to suck, but chances are it’s not going to suck quite as much as you think it will. It also depends on which chemo you get — there tend to be three options, AC+T, which is the strongest/hardest option, TCHP, which is often standard for HER2, and is hard, but not as hard as AC+T, or the final option for smaller tumors, just Taxol (the T of AC+T), which isn’t as harsh as the other two. Everyone reacts differently of course. Some people struggle with just taxol and other handle AC+T with no major issues.

  • mountainmia
    mountainmia Member Posts: 857

    melbo, as you say, someone may or may not be able to tolerate one option and do reasonably well on another. I reacted to Taxotere (of the same family as Taxol), so I was not a candidate for AC + T. However, I did AC only and did okay with it. The size of my tumor and no positive lymph nodes made that an option for me, with triple negative (NOT triple positive).

  • greenbean2468
    greenbean2468 Member Posts: 18

    Hi ruby216,

    Everyone has explained this really well already. Just writing to say, I'm right there with you--triple positive asking this same question 3 months ago. I tried to bargain with my surgeon, if I had surgery first, was there the possibility I wouldn't need chemo? He wouldn't budge and I was frustrated for a while that he and my MO were overreacting to a very small tumor. Over time, I'm become extremely grateful. Her2 pos is aggressive and it needs to get hit hard so it doesn't come back. My surgery will be after my chemo. I'm now halfway through my 6 dose TCHP and as has been said, it's hard but not as bad as I imagined. Best wishes for your surgery. So sorry you're having to go through this.