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Topic: Stage 1, grade 1 and pre-menopausal

Forum: Stage I Breast Cancer — Meet other members with a Stage I breast cancer diagnosis to share information and support.

Posted on: Aug 23, 2011 05:25AM - edited Jun 12, 2012 05:18PM by Annicemd

Annicemd wrote:

hi sisters,
It has struck me that most grade 1, stage 1 sisters seem to be post-menopausal (aka low estrogen) and younger women seem to be more often stage 2/grade 2. I am 42, recently diagnosed ER positive, still full of estrogen and becoming a little paranoid that there is something different about me or my cancer! I am not having chemo as i dont qualify for it. Low oncoDX score etc. On tamoxifen but am a little worried that my long term outcome may be worse because am am in no-mans land!! Are there any sisters out there in similar situation??***************************************************************************************************

May 2012 Decided to update this post as your responses have shown me that there are many of us who started out premenopausal with stage 1 grade 1 disease! What has become evident is that the choices for treatment can be tricky for us. Dilemmas include whether or not to use ovarian suppression or ooph (the definitive study - the SOFT trial will start to publish results hopefully around winter 2013), whether to do chemox if oncotype is intermediate (there is a study looking at this -The TAILORx but results are years off, whether adding zometa to treatment helps reduce recurrence (data remain somewhat conflicting although there appears to be a benefit for women over 40 years provided they are also treated with ovarian suppression), whether ovarian suppression alone or in combination with AI is a good alternative to tamoxifen for those of us who can't take/tolerate tamoxifen (TEXT trial results anticipated with SOFT results) and does Cyp2d6 status matter? So if you are stage 1, grade 1 and diagnosed when you were pre-menopausal you are definitely not alone. There is not a "one size fits all" answer to how we should be treated but hearing the treatment routes others have chosen does help with decision making... and optimism, there are 20 year survivors posting here! >

Multifocal IDC, oncoDX 8 & 1. No chemo. Left Mx, exchange to implant April 25th 2012. Tamoxifen & zoladex Dx 6/22/2011, IDC, 1cm, Stage I, Grade 1, 0/10 nodes, ER+/PR+, HER2-
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Nov 10, 2016 03:03PM KathyL624 wrote:

Are you being treated at a local hospital or a university or NCI hospital? I was 38 when diagnosed with a Stage 1 Grade 1 tumor and they didn't question the pathology, just told me I was lucky because younger women typically have more aggressive cancers. Also, oncotype was automatically ordered, despite my stats and the mitotic rate being 1.

Dx IDC, Left, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Nov 10, 2016 03:16PM SummerAngel wrote:

I was 45 and premenopausal when diagnosed with bilateral grade 1 tumors, and no one said anything about me being lucky until the low Oncotype score came back for the larger tumor.

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 4/3/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/28/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Nov 10, 2016 10:02PM treelilac wrote:

Did you ladies not have hormone therapies either? I'm wondering because I don't see them in your signature sections.

Left MX with TE (11/2010) @ Age 42--microinvasion-> stage I (post op). BRCA-. Tamoxifen 3 yrs. Right Pleomorphic ILC (3/2015), DCIS 2 cm, LCIS 8 cm (post op). BRIP1+. Oncotype 11. Dx 9/17/2010, DCIS, Left, 1cm, Stage 0, Grade 1, 0/3 nodes, ER+/PR+ Surgery 11/8/2010 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement; Reconstruction (right): Silicone implant Dx 3/27/2015, ILC, Right, 1cm, Stage IA, Grade 2, 0/6 nodes, ER+/PR+, HER2- (FISH) Surgery 5/11/2015 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy; Reconstruction (right): Silicone implant Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 11, 2016 09:04AM SummerAngel wrote:

I discontinued Tamoxifen within a few months because I couldn't tolerate the side effects (my posts about that are in the Bottle o' Tamoxifen thread). My MO said that I could try ovarian suppression and an AI if I wanted to but that he expected the problems to be just as severe or more so, and because my risk of recurrence is so low he gave his blessing for me to quit. I was very surprised at the side effects, I typically do fine with meds.

Age at dx: 45. Oncotype, left-side tumor: 9. Right side had multifocal IDC and "extensive" LCIS. Isolated tumor cells in 1 right-side node. Dx 4/3/2015, IDC, Left, 2cm, Stage IIA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 4/27/2015, IDC, Right, 1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2- (FISH) Surgery 6/1/2015 Lymph node removal: Sentinel; Mastectomy: Left, Right Surgery 6/1/2015 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/28/2015 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant Surgery 12/4/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Nov 11, 2016 10:59AM treelilac wrote:

Thank you, Angel. I tried Tamoxifen for 3 years then quit. I tried AI next for 9 months. My MO wants me to continue (Oncotype 11) so I feel curious about others' decision-making. I hope I'm choosing the right one (finger crossed)!

Left MX with TE (11/2010) @ Age 42--microinvasion-> stage I (post op). BRCA-. Tamoxifen 3 yrs. Right Pleomorphic ILC (3/2015), DCIS 2 cm, LCIS 8 cm (post op). BRIP1+. Oncotype 11. Dx 9/17/2010, DCIS, Left, 1cm, Stage 0, Grade 1, 0/3 nodes, ER+/PR+ Surgery 11/8/2010 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): Silicone implant, Tissue expander placement; Reconstruction (right): Silicone implant Dx 3/27/2015, ILC, Right, 1cm, Stage IA, Grade 2, 0/6 nodes, ER+/PR+, HER2- (FISH) Surgery 5/11/2015 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy; Reconstruction (right): Silicone implant Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Nov 15, 2016 05:54PM poopysheep wrote:

I'm leaning towards just not doing tamoxifen either... or rads at this point. I'm going to see a Naturopathic Oncologist (who even knew that was thing) to see what he has to say. I'm not a super granola-ish person but I am intrigued anyway.

Dx 9/1/2016, DCIS/IDC, Right, 1cm, Stage IA, Grade 1, 0/4 nodes, ER+/PR+, HER2- Surgery 10/4/2016 Lumpectomy: Right; Lymph node removal: Sentinel
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Nov 15, 2016 06:51PM KathyL624 wrote:

I am doing ovarian suppression and an A.I

Dx IDC, Left, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Nov 21, 2016 02:58PM - edited Nov 30, 2016 07:36PM by maryny16

This Post was deleted by maryny16.
Hormonal Therapy Arimidex (anastrozole), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal: Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy Arimidex (anastrozole)
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Dec 15, 2016 05:00PM LuvLulu07 wrote:

Has anybody had their early stage tumor tested for a later recurrence - beyond 5 years? MO tells me that it's relatively new test.

Thx



Nov. 2011 NSS BMX direct to implants Tamoxifen, Zoladex Dx 9/27/2011, IDC, Left, 1cm, Stage IA, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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Dec 15, 2016 08:45PM voraciousreader wrote:

yes. I had the test.

https://www.breastcancerindex.com/



Doctor told me regarding my prognosis that I WASN'T on the Titanic! Hmmm...Really?....Okay! 02/2010 Pure Mucinous Breast Cancer, Oncotype DX 15, Stage 1, Grade 1, 1.8 cm, 0/2 nodes, ER+ 90% /PR+ 70% HER2- (+1)
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Dec 16, 2016 01:34AM Annicemd wrote:

Thanks for sharing this VR. Good to know for a lot of ladies on this thread

X

Multifocal IDC, oncoDX 8 & 1. No chemo. Left Mx, exchange to implant April 25th 2012. Tamoxifen & zoladex Dx 6/22/2011, IDC, 1cm, Stage I, Grade 1, 0/10 nodes, ER+/PR+, HER2-
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Dec 16, 2016 10:30AM LuvLulu07 wrote:

Thank you, VR.

Yes, this is the test that MO mentioned. Excited to think of the possibility of quitting Tamoxifen at five years. :)

Nov. 2011 NSS BMX direct to implants Tamoxifen, Zoladex Dx 9/27/2011, IDC, Left, 1cm, Stage IA, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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Jan 12, 2017 12:18PM ssimplelife2 wrote:

Hi all, I'm newly diagnosed and reading this tread has been enormously helpful! Thank you to all of you for sharing your journeys! I'm still healing from the rt lumpectomy and node biopsy so i have only met with my oncologist's nurse navigator at this point. I am pre-menopausal, suspect I am in Peri-menopause, my mom entered menopause in her early 50's. I have some questions if anyone can help - Before this diagnosis i had been feeling "off" so over the summer I had my hormones tested (saliva test) and it showed my estrogen was normal but my cortisol and progesterone were low making me estrogen dominant. I am suspecting i was in that state for possibly years looking back now at my symptoms but like many women, I did not take care of myself, working, kids, taking care of ill parents, and then having 5 family members pass away within a 14 month period (including my mom) produced years of heavy stress. I think this all contributed to the hormone imbalance and ultimately the BC.

Here are my questions 1. Is an imbalance in hormones the cause of ER+ and PR+ BC? It's seems like it is. 2. Are there any studies indicating women's' hormone levels prior to a BC diagnoses? 3. If we can simply balance our hormones, will this prevent a recurrence? Are there any studies related to this? 4. Or do we have to take some kind of HRT to get rid of our estrogen altogether (or remove our ovaries)?

Dx 12/13/16, IDC, Stage 1, Grade 1, .6cm, 0/2 Nodes, ER +80, PR +100, Oncotype 13, Surgery 12/6/16 Rt Lumpectomy, 12/19/16 Rt medial margin excision and Rt sentinal node biopsy
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Jan 12, 2017 02:54PM Moderators wrote:

Dear ssimplelife2,

Welcome to the community. We are so glad that you reached out here but so sorry for your diagnosis and all that you have been through. You may want to explore other forums if you do not receive responses here. You can also take a look at our main site for more information. Here is a link to a page on Hormone Receptors. Please stay connected here and keep us posted. The MOds

To send a Private Message to the Mods: community.breastcancer.org/mem...
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Jan 12, 2017 09:00PM ssimplelife2 wrote:

Thank you and yes I will look at that. I was hoping annicemd would respond since this is her area of expertise and she always has so much good info. But yes, I may post this in another forum also.

Dx 12/13/16, IDC, Stage 1, Grade 1, .6cm, 0/2 Nodes, ER +80, PR +100, Oncotype 13, Surgery 12/6/16 Rt Lumpectomy, 12/19/16 Rt medial margin excision and Rt sentinal node biopsy
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Jan 13, 2017 10:36AM Annicemd wrote:

hi Simplelife, sorry you have had to join us. Glad you found the thread.

You have asked some very searching questions! I will try my best to answer them.... here goes

1. Is an imbalance in hormones the cause of ER+ and PR+ BC?

The cause of ER+ PR+ BC like other forms of BC, is poorly understood. It is most likely multifactorial with contributions from genes and environment. There is no strong suggestion that hormone imbalance is the cause but high estrogen levels over many years from the birth control pill or hormone replacement therapy do increase risk. The hormone imbalance you describe about yourself seem to me, based on the info you have given, to be that you were perimenopausal which can cause estrogen levels to be very high as well as very low, and suffering from adrenal fatigue which is and adrenal imbalance caused by stress. Stress is bad for the immune system but many people suffer from chronic stress and don't get cancer! But of course it may be one ingredient in the complex cancer recipe!

2. Are there any studies indicating women's' hormone levels prior to a BC diagnoses?

I don't know the answer but I think no good evidence to show this, you will always find anecdotes from "Dr Google"

3. If we can simply balance our hormones, will this prevent a recurrence? Are there any studies related to this?

With ER+ breast cancer suppressing estrogen levels helps to reduce risk of recurrence. That is why Tamoxifen, aromatase inhibitors and ovarian suppression are often used. Some of the benefits of chemotherapy in younger women may also relate to the fact that it suppresses ovary function and sometimes triggers early menopause. There are no data looking at any sort of "rebalancing of hormones". However stress is bad for ALL chronic illnesses and cancer is no different and reducing stress is only going to be beneficial.

4. Or do we have to take some kind of HRT to get rid of our estrogen altogether (or remove our ovaries)?

I think I answered this above?

I wish you all the best with your treatment plan

Annicemd

Multifocal IDC, oncoDX 8 & 1. No chemo. Left Mx, exchange to implant April 25th 2012. Tamoxifen & zoladex Dx 6/22/2011, IDC, 1cm, Stage I, Grade 1, 0/10 nodes, ER+/PR+, HER2-
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Jan 13, 2017 06:36PM ssimplelife2 wrote:

Thank you Annicemd! Your answers were really helpful, there's so much to understand with this diagnosis. I wish you the best!

Dx 12/13/16, IDC, Stage 1, Grade 1, .6cm, 0/2 Nodes, ER +80, PR +100, Oncotype 13, Surgery 12/6/16 Rt Lumpectomy, 12/19/16 Rt medial margin excision and Rt sentinal node biopsy
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Feb 27, 2017 01:46PM rae41 wrote:

I am just like you!! I found my lump in Feb of 2015(age 41). I went for my yearly mammogram, they saw nothing so I ignored it till August. At that point I asked for an ultrasound and ended up with a biopsy that same day. six days later on 9-1-2015, I found out I had BC. it ended up being STAGE I, IDC lo grade, 1 CM. no lymph nodes involved. I have wondered the same thing, I am still having regular periods, Im alos on Tamoxifen, Oncotype score or 14.

Dx 9/1/2015, IDC, Left, 1cm, Stage IA, Grade 1, ER+/PR+, HER2- Surgery 10/9/2015 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Prophylactic mastectomy: Right; Reconstruction (left): Silicone implant, Tissue expander placement; Reconstruction (right): Silicone implant, Tissue expander placement Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 18, 2018 02:53AM - edited Feb 18, 2018 05:31AM by Valentina7

This Post was deleted by Valentina7.
Dx 11/27/2017, IDC, Right, <1cm, Stage IA, Grade 1, 0/5 nodes, ER+/PR+, HER2- Surgery 12/21/2017 Lumpectomy: Right; Lymph node removal: Sentinel Hormonal Therapy 1/13/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/23/2018 3DCRT: Breast
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Mar 5, 2018 08:31AM Valentina7 wrote:

hi everyone,

I just finished reading all posts! I wanted to make sure I was well informed before asking stupid things. I was diagnosed in November, only 33 years old.

my tumor was really small 3 mm. The final report says: NST but with predominantly tubular components. Is it then tubular? I asked one oncologist and she said..it means the tumor is not that malignant..

I finished my rads and I am trying to enjoy short vacation with my husband but I am so worried about a recurrence or getting cancer in the other breast.. My doctors always tell me I have very good prognosis but I am worried because I am only 33..and my cancer is ER/PR+. I am now only taking tamoxifen, would it be enough??? Any experience? What else I can do? I started a diet that I am willing to keep my whole file, I exercise regularly...i don't smoke and drink alcohol and I am willing to reduce my stress...i am a very stressed person.

I used BC pills for 15 years and I think this played an important role. I am of course not using this anymore.

I worry that the radiation will cause my another cancer in some years...i begged for another treatment but I am currently in Germany and my doctors said mastectomy was extreme and unnecessary

any advice? Any help?

tganks

Dx 11/27/2017, IDC, Right, <1cm, Stage IA, Grade 1, 0/5 nodes, ER+/PR+, HER2- Surgery 12/21/2017 Lumpectomy: Right; Lymph node removal: Sentinel Hormonal Therapy 1/13/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/23/2018 3DCRT: Breast
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Mar 12, 2018 05:25PM peggy_j wrote:

Hi Valentina,

Congrats on finishing rads. I was pretty tired at the end of rads, and then went through a period of severe insomnia for about 6 weeks (practically no sleep at all, day after day, for 6 weeks. gah! I thought it was due to tamox but realistically I think it was everything catching up to me). I am also a skeptical person, distrusting when my docs said I had a great prognosis. But I think they are being honest, based on what they have seen. And here I am 7 years later, so they couldn't have been bluffing me too much. lol. Anyway, in terms of things to do, I chose to stop drinking alcohol, I make more of an effort to eat only organic, and limit my exposure to chemicals (got rid of the plastic tuperware for glass, use a ceramic drip coffee maker vs. the plastic Mr Coffee, bought Green Pan cookware, use health body care and household cleaning products etc). I have no idea if any of these things caused my cancer but I figure, better safe than sorry. I did it little by little and realistically, most of them were upgrades (glass leftover containers are much nicer than plastic). In terms of radiation, I think it's a good idea for everyone to reduce excess exposure. I avoid excess medical scans if not needed. (my ear doc wanted to do a brain CT to look for scar tissue in my ear and I said "no thanks" since it wouldn't really change what we were doing anyway). I choose to opt-out of the back-scatter machines at the airport. Also, since being on a plane increases our exposure to the sun's radiation, I take antioxidant vitamins when I fly. And I fly red-eyes more often (no sun == no sun's radiation). Realistically, I take the red-eyes more for the schedule/traffic convenience but it's nice to reduce the radiation exposure. This might sound overwhelming. I know someone who is a 35+ year BC survivor (DX'd at 31, ages ago when our Tx options were less; she had an MX and was done). She doesn't make any special effort, really, and she's still doing great.

BTW, did you get tested for the BRCA gene? It's less $ than it used to be.

take care of yourself. You've been through a lot. It's a big deal, especially when you are young. I'll send you good thoughts.

Patti


Dx 2/2011, IDC, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Mar 13, 2018 12:14AM Valentina7 wrote:

hi Patti,

thank you so much for your messages.

I am having the BRCA test in 2 weeks.

many greetings from G

Dx 11/27/2017, IDC, Right, <1cm, Stage IA, Grade 1, 0/5 nodes, ER+/PR+, HER2- Surgery 12/21/2017 Lumpectomy: Right; Lymph node removal: Sentinel Hormonal Therapy 1/13/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/23/2018 3DCRT: Breast

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