Chemo or not?
Hi ladies, i just got back from my oncologist appointment.
My current condition:
I had a single mastectomy on my right breast. Final pathology showed idc 2.2cm with dcis, grade1, ki67 5-7%. Er/pr+, her2- (fish and oncotype dx confirmed), no lymph node/vascular involvement 0/6. My oncotype score is 11, 3% recurrence in 9 years, less than 1% benefit of chemo.
My doctor said no chemo, but i insist and she said if i insist then she will give me chemo. I also asked her if i were her daughter, would you give me chemo? She said no.
So i ended up taking hormone therapy only. Aromasin and monthly lucrin injection (after 3 years, then can do every 3 monthly) i'm 42 yo
Now, i'm having 2nd thought! Should i do chemo instead?
Comments
-
I would go with my doctor's recommendation. Less than 1% benefit is not worth all the potential (and sometimes lifelong0 side effects chemo can have.
1 -
Hi ruth, thx for the reply, i'm worried that my surgeon only took out 6 nodes. What if the other nodes are positive even if they're clear on mri/pet scan/mammogram/ultrasound. Then the oncotype dx result would have been different
0 -
Molly - the doctors weight the benefits vs. the risks of chemo. Taking out 6 nodes is quite a bit and typically breast cancer would move to the sentinel (first) nodes initially. I also had Stage 1, grade 1 BC. It was just a bit larger than yours and my Mammaprint was similar to your Oncotype. Many doctors do not use the Ki-67 in calculating benefit of chemo as studies have not shown a benefit and Oncotype is considered more accurate.
If you are concerned you can always get a 2nd opinion. I am older than you (63 at diagnosis) but even with my genetic mutation that causes a high risk for breast and ovarian cancer, my treatment was a lumpectomy and radiation. My surgeon refused to give me a mastectomy as survival rates are equal between the two surgical options.1 -
Now days 6 nodes is actually quite a few for an early stage cancer, so I think they have been very cautious.
1 -
Okay, thank you ladiess for your input. Helps me feel more sure and confident in choosing the right treatment! I hope we all can get through this and live very long healthy life 🤗🤗🤗
0 -
ER+/PR+/HER2- tumors are not rapidly-dividing, especially if they are Grade 1, Stage I, node-negative, clean margins and low OncotypeDX. 11 is a low score, and even before the range of "low-risk" scores was expanded upwards a few years ago it was considered low risk. A 1% benefit of adding chemo is more like a "rounding error," because nobody can accurately say "zero." Chemotherapy is "cytotoxic:" by design it kills rapidly-dividing cells; and in the case of a tumor like yours (or mine), it wouldn't even work—it would do more harm than good. Stick with your doc's recommendation of endocrine therapy and you'll be fine!
Note: I had 4 nodes removed, all negative but only 2 were "sentinels;" the others were stuck to them. If the sentinels are negative, any nodes further down the line would be too. (BTW, in women >65 with this type of IDC, sentinel-node biopsy is now considered an option rather than a necessity—this from the same surgeon who pioneered SNB (my surgeon, BTW).
1
