New Protocols
I am a 10 year survivor of breast cancer (stage 1a, ER/PR+, HER2+). Now my 75 year old sister has been diagnosed with stage 1a, ER+,HER2- breast cancer. She Iives in a distant state, so I cannot go with her to all of her doctor's appointments. She saw her oncologist today for the first time and was told she is most likely to have a lumpectomy followed by 2-3 weeks of daily radiation and then treatment with a hormone blocker. Her doctor said she might not need a sentinel node biopsy (which I had when I had my lumpectomy after 6 round of chemo). There was also no mention of genomic testing such as Oncotype DX or MammaPrint and no plan for her to have a PET scan before treatment. While I did not have Oncotype or MammaPrint testing, I had a PET scan. Can anyone tell me if the above sounds like standard procedure for treating early stage breast cancer in an otherwise healthy woman in her 70's. Thanks.
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Hi @katmil, Recently oncologists have focused on making breast cancer treatment less toxic and more personalized. Studies have shown that sentinel lymph node biopsy makes no difference to survival in women older than 70 with early stage cancer and can therefore be skipped. PET scans are now done only for those diagnosed with stage 3. While tests like the Oncotype DX are useful in determining whether chemo would be beneficial for those with ER+/HER2- cancer, toxic side effects are likely to occur in women over 70 making chemo more dangerous than beneficial. Studies have also shown those over 70 with stage 1 bc can skip radiation if they take hormone blockers. Your sister is receiving treatment which is standard of care for a healthy woman in her 70’s. I hope her treatment goes well.
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I don't know why I did not see this before. Thanks so much for your comments. I have researched this myself and found pretty much the same info. BTW, since my original post, she was also diagnosed with stage 1 lobular breast cancer in the same breast, the tiny spot is right next to the original tumor. On Wednesday she will have a single lumpectomy to remove both tumors. She WILL have a sentinel node biopsy, now recommended by her surgeon since the second spot was discovered. Looks like there are no plans for a PET scan or Oncotype DX.
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Hi @katmil, It's fortunate that your sister's additional tiny tumor is right next to the original one since it won't affect the surgery plan. It's a good idea to have the sentinel node biopsy since there are two tumors. An Oncotype is only done if the patient is considering chemo and the tumor is greater than 5 mm (T1b). A PET scan is generally done only for stage III patients. I hope your sister's surgery and recovery go well.
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Thanks so much! I'm leaving tomorrow to fly to NM to be with her for the surgery.
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