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Topic: Chemo confusion

Forum: Stage II Breast Cancer — Meet, share and support others with Stage II Breast Cancer

Posted on: Mar 6, 2019 06:25AM

Bookwormgurl wrote:

This is my first time posting and I am confused. I had unilateral mastectomy for a 1.2 cm idc and asmall dcis at the beginning of February and during surgery they found two positive (macro mats) lymph nodes. I was told after surgery I would likely need chemo but I am so confused because I have er+, her2-, low ki-67 (<10) and my oncotype score came back at an 8. One oncologist said he would recommend TC chemo and the second opinion oncologist I saw yesterday said she would do dose dense A-CT. it Did anyone with similar scores do dose dense A-CT? It seems like most people in this group that have similar scores etc do the tc, so I was a bit surprised to hear A-CT was recommended by the second oncologist. Her main Reason was that it had gone to the lymph nodes and it was standard of care.. I am trying to wrap my head around everything but it just seemed so different from what I have read on here and other places. Any thoughts would be appreciated. thanks

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Mar 6, 2019 06:48AM keepthefaith wrote:

I'm not in a similar situation, but the Dr's look at many aspects of your diagnosis. The Onco-score is just one piece of the puzzle. It's great that you are getting more than one opinion. You didn't mention the grade of the tumor. Higher grades respond better to chemo than lower grades. Hopefully someone with more knowledge will chime in with more information. Ultimately, it is your decision to make. Best wishes!

Dx 9/17/2013, IDC, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 10/18/2013 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 12/3/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Chemotherapy 12/26/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Chemotherapy 1/16/2014 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Chemotherapy 2/11/2014 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 4/1/2014 Breast Hormonal Therapy 5/23/2014
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Mar 6, 2019 06:56AM Bookwormgurl wrote:

keepthefaith - thank you for responding. That is a good point. My grade is a grade 2, so maybe that is part of what played a part in her recommendation for A-CT.

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Mar 6, 2019 07:14AM - edited Mar 6, 2019 07:17AM by LeesaD

Post mastectomy pathology showed two sentinal nodes with micromets. My MO ordered Oncotype. I had ALND prior to Oncotype results coming back. The ALND pathology showed 2 of 14. more nodes fully positive. My MO set me up for AC-T chemo. After port placement my Oncotype results came back and result was a score of 3. My MO encouraged by the low score changed the chemo to TC. He said the heart risk from the Adriamyacin outweighed what he thought would be any benefit now with such a low score. He presented the case to the tumor board and they all agreed on the TC since there were 4 involved nodes even though two with just micromets. My tumor grade 2 also.

Oncotype Score 3, 2/4 Sentinal Nodes micromestasis so pushed for ALND for 'peace of Mind' and surprise found 2/14 positive axillary nodes Dx 2/3/2017, IDC, Right, 3cm, Stage IIB, Grade 2, 4/18 nodes, ER+/PR+, HER2- Surgery 3/27/2017 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/17/2017 Lymph node removal: Underarm/Axillary Chemotherapy 5/9/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 8/2/2017 Hormonal Therapy 9/7/2017 Arimidex (anastrozole), Zoladex (goserelin) Surgery 11/17/2017 Prophylactic ovary removal Surgery 1/30/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Mar 6, 2019 08:48AM Moderators wrote:

Hi Bookwormgurl, and welcome to Breastcancer.org,

We're so sorry for the reasons that bring you here, but we're really glad you've found us. As you can already see, our Community is full of amazing members, always willing to offer information, advice, and support.

We also wanted to share this page from the main Breastcancer.org site, that you may find helpful: Choosing a Chemotherapy Combination. There's also some good advice on questions to ask your doctors about the regimen they are suggesting on the Talking to Your Doctor About Chemotherapy page.

We hope this helps and we look forward to hearing more from you soon!

--The Mods

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Mar 6, 2019 10:15AM InnaB2018 wrote:

I had one node with a 7 mm macromet. Grade 3 tumor. I had DD AC-T because of it. My doctor didn’t even send for the Oncotype test. She said it’s not a standard of care. If have a positive node, i’ve Got to have chemo. And because of grade 3, I got the strong one.

Dx 3/26/2018, IDC, Right, 3cm, Stage IIA, Grade 3, 1/18 nodes, ER+/PR+, HER2- Surgery 4/24/2018 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 6/1/2018 AC + T (Taxol) Radiation Therapy 10/7/2018 3DCRT: Breast, Lymph nodes, Chest wall Hormonal Therapy Arimidex (anastrozole)
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Mar 6, 2019 11:38AM Runrcrb wrote:

talk to your oncologist and feel free to get a second or third opinion. As someone noted the ultimate decision is yours. I have always felt that I needed to be comfortable and confident in the plan, whatever that plan was, in order to sleep at night and feel I’d done what was necessary to beat cancer.

Dx 6/27/2016, IDC, Right, 1cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Dx 6/27/2016, ILC/IDC, Right, 2cm, Stage IIB, Grade 1, 4/10 nodes, ER+/PR+, HER2- Surgery 9/22/2016 Lymph node removal: Right; Mastectomy: Right; Reconstruction (right): Tissue expander placement Chemotherapy 10/31/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 2/9/2017 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 4/23/2017 Arimidex (anastrozole), Aromasin (exemestane) Surgery 12/13/2017 Reconstruction (right): DIEP flap
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Mar 7, 2019 12:37PM Bookwormgurl wrote:

thanks everyone. I think I am starting to wrap my head around chemo just need to decide which one. In the meantime I’m waiting for some other test results

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Mar 8, 2019 04:37PM MexicoHeather wrote:

I think my treatment was based on the grade. One of the cancerous lymph nodes was rather large, too.

Dios es Amor. Dx 10/1/2016, IDC, Right, 3cm, Stage IIB, Grade 3, 3/17 nodes, ER+/PR+, HER2- Surgery 12/4/2016 Lymph node removal: Right; Mastectomy: Right Surgery 12/4/2016 Lymph node removal: Underarm/Axillary; Mastectomy: Right Chemotherapy 1/18/2017 AC + T (Taxol) Radiation Therapy 5/9/2017 Whole-breast: Lymph nodes, Chest wall Surgery 10/9/2017 Prophylactic ovary removal Surgery 12/5/2018 Hormonal Therapy Arimidex (anastrozole) Hormonal Therapy Femara (letrozole) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)

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