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Apr 25, 2021 10:26AM
Venus, IDC grade 3 is part of the diagnosis but that's too generalized / high level. To determine the treatment plan and the amount of benefit from rads and anti-hormone therapy, other important factors are:
- the size and focality of the tumor (one area of cancer or more than one, how widely spread out?)
- the size of the surgical margins (was the cancer within the breast tissue that was removed surrounded by a large area of non-cancerous tissue, or did the cancer come right up to the edge of the removed tissue?)
- whether there is nodal involvement
- the ER and PR status (and percent strength of ER and PR, if ER+ and PR+)
- whether the cancer is HER2+ (I'm assuming not, since it appears that chemo is not being recommended)
- the Oncotype or Mammaprint score (usually but not always done for ER+ / HER2- cancers).
Does your mother have a copy of her biopsy and surgery pathology reports, and the imaging reports? This is important information that she needs to make her treatment decisions. Is your mother just dealing with a surgeon at this time, or has she seen a Medical Oncologist? Beyond surgery, the treatment plan should be managed by the MO. Surgeons operate; MOs do the rest.
My advice is to take a step back to review the situation. You've jumped to alternative treatments without understanding why the traditional treatments have been recommended and how much risk your mother faces and how much benefit your mother will get from these traditional treatments. As other posters have pointed out, many older patients tolerate these treatments well. But before your mother makes any decision on whether or not to go ahead with either rads and/or anti-hormone therapy, and before you start thinking about alternative treatments, at the age of 87 what your mother really needs to understand is the amount of risk she faces - both local recurrence risk and metastatic recurrence risk - and the amount of risk reduction she will get from rads and anti-hormone therapy. Rads is given to reduce the risk of a localized (in the breast area) recurrence. If she had a large grade 3 tumor and narrow surgical margins, her risk might be very high, in which case the benefit of rads would be significant and to my understanding there are no alternative treatments that can address this. But if her tumor was small and the surgical margins were large, her risk might be quite small, in which case the benefit of rads would be even smaller. Anti-hormone therapy reduces the risk of both a localized recurrence and a distant/metastatic recurrence. Your mother's risk of a metastatic recurrence depends on many elements within the pathology - her MO is the doctor she should talk to about this. Here again, if her risk is relatively low, and considering that mets may take many years to develop, there might be little risk reduction benefit from taking anti-hormone therapy. But if based on the pathology of her cancer, her risk is very high, then the benefit will obviously be greater and your mother might decide to try anti-hormone therapy (she can always try them to see how well she tolerates these meds).
Is your mother making her own decisions, or has she asked for input from you (or the family in general) or are you actively involved with her care (attending appointments with her)?
Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole