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Topic: Stage 2A Chemo or no chemo

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

Posted on: Sep 9, 2019 12:51AM

TJF wrote:

I was diagnosed with DCIS after a Stereotactic biopsy. I had a lumpectomy on 9/3 and I got my pathology results today, I had IDC with the DCIS. Pathology report staged it at a 2 since I had 2 areas, one was 27mm IDC and DCIS and a 22mm of DCIS, my surgeon stated they got clean margin and the lymph nodes were negative. The pathology report stated ER+/PR- and the HER2 is pending.

I had been told previous to surgery that I would need Radiation and Hormone therapy but now I am wondering if I am also going to need chemo.Has anyone else had a similar diagnosis? Did you need chemo?

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Sep 9, 2019 01:01AM Spoonie77 wrote:

I was told prior to surgery that I would need 6 months of Chemo most likely. After surgery, even though they found DCIS in addition to the known IDC, my nodes were negative and my Oncotype predicted low to no benefit for chemo. My MO left it to me to make the final call. So it's possible that it could change for you as well. I was both PR & ER+ though. It may be different because of the PR- factor.

I sometimes wonder if I should've done chemo anyway. If I had it to do over again I would've asked more questions, especially concerning the fact the research trial info on Oncotyping is more geared to those postmeno rather than pre., before deciding to skip it. I wonder what difference that plays in effective vs risk/harm for chemo.

Anyway, I wish I could give you answers but the only people who can are your drs. Keep asking questions until you are sure of your decision, either way. That's my best advice after having gone down my path already.

Life long "Spoonie". Entered the BC world @41 w/ DX of IDC. DXd @ 42 w/ MS. Treatment: LX/SLNB/RADs. Plan A: 5mg Tamoxifen = 0 QOL. Plan B: Zoladex = Confirmed Allergy. Plan C: Unknown, the journey continues. PS: Not a doctor, just a curious Googler. Dx 7/20/2018, IDC, Left, 3cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Dx 8/30/2018, DCIS, Left, 1cm, Stage 0, Grade 2 Surgery 8/30/2018 Lumpectomy: Left; Lymph node removal: Left, Sentinel Radiation Therapy 10/1/2018 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 3/30/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 7/2/2019 Zoladex (goserelin)
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Sep 9, 2019 09:21AM OnTarget wrote:

I would imagine that they'd do an oncotype test and decide on chemo based on the results combined with your particular cancer attributes.

The only thing I would dig into is your age and how that alters your actual recurrence risk and absolute chemo benefit. The generic oncotype results do not currently take into account clinical risk or age, so you need more info to know your specific recurrence risk.

Diagnosed at 42, Oncotype score 16, ITC in one node- considered node negative Dx 4/8/2019, ILC, Left, 3cm, Stage IB, Grade 2, 1/3 nodes, ER+/PR+, HER2- Dx 4/23/2019, ILC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 5/15/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 6/14/2019 Zoladex (goserelin) Chemotherapy 8/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Sep 12, 2019 11:19PM TJF wrote:

I am hoping someone out there has also go through this and can share their story. I had a lumpectomy for what was biopsied as DCIS, after the final that was in it states 27mm of IDC and 22mm of DCIS. They attempted to do a sentinel node dissection, the injected the radioactive isotopes and the dye but the sentinel node didn't take either, they found 1 lymph note and took it but couldn't locate any sentinel nodes. The 1 node they did take came back negative but when I met with my surgeon and Oncology MD today they are now suggesting s lymph node dissection and removing all the lymph node since they cant go back in for the sentinel and they are unsure if the IDC has spread. The Rad Onc MDs state that if it had spread that the radiation will kill it and that I shouldn't have the surgery. Has anyone else ever gone through this?

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Sep 12, 2019 11:59PM - edited Sep 13, 2019 12:02AM by Legomaster225

TJF, I have a somewhat similar issue. My cancer was only identified in my right breast and one lymph node initially. After surgery I was found to have IDC and DCIS is my left breast as well. (I had a BMX but we thought the cancer was only on my right side). Anyway, because nothing was suspected on the left, no sentinel node testing was done on that side. After surgery it is to late to do testing and no nodes were found in the tissue that was removed. I discussed it with my team and it was decided that I would not do a full node dissection but would instead just monitor the lymph nodes with ultrasound annually and through manual exams with my MO and BS. We believed the risk of dissection and lymphedema outweighed the benefit at this point. I pray everyday that I made the right decision. I am also taking Aromasin as my cancer is Er+. I am two years out and am closely monitored but everything is ok so far.

I had pre-adjuvant chemo and I had a node on my right side that was positive at biopsy but was negative when it was removed so we are also hoping that if anything was on the left side would have been cleaned up by the chemo as well. I had radiation but only on the right side.

Not exactly the same situation as you but I hope this helps. Did they order an oncotype test on your biopsy? That should give you more information as to whether or not chemo will be beneficial.

Diagnosed at 50. Currently 53. Oncotype score 39. One node positive at diagnosis negative after preadjuvent chemo. Bilateral cancer discovered at BMX. Left breast was supposed to be prophylactic. :-( Dx 12/3/2016, IDC, Right, 3cm, Stage IIB, Grade 2, 0/4 nodes, ER+/PR+, HER2- Chemotherapy 1/19/2017 AC + T (Taxol) Dx 6/22/2017, IDC, Left, <1cm, Stage IB, Grade 1, 0/0 nodes, ER+/PR+, HER2- Dx 6/22/2017, DCIS, Left, <1cm, Stage 0, Grade 1 Surgery 6/22/2017 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Radiation Therapy 8/22/2017 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 10/17/2017 Hormonal Therapy 9/9/2018 Aromasin (exemestane)
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Sep 13, 2019 12:11AM TJF wrote:

Yes, Oncotype testing was ordered today. I am just left feeling very confused.

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