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All TopicsForum: Chemotherapy - Before, During, and After → Topic: why do I need chemo after lumpectomy with clean nodes

Topic: why do I need chemo after lumpectomy with clean nodes

Forum: Chemotherapy - Before, During, and After —

Regimens, side effects, and support from others going through chemo.

Posted on: May 18, 2009 06:55PM

aaronali12 wrote:

I just had my lumpectomy on april 30th and got back clean  margins and they removed 4 nodes. they were clean. I went to see two different oncologists. The first one wanted to do a test on my tumor and see what grade it is and than decide if I need chemo. I definitely need radiation and I have to go on tamoxifen which I am not happy about. does anyone have info on tamoxifen???anyway I went to another oncologist and he wants to do 4 rounds of chemo 1 time  every 3 weeks. I also have to get a port. He said the reason for chemo is to lower my reoccurrence rate. I just wanted to know if anyone had a lumpectomy with clean nodes and had chemo. I am really scared of the chemo. I would love any advice. Thank you and god bless

Dx 3/23/2009, IDC, 1cm, Stage I, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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May 18, 2009 07:01PM crusader1 wrote:


I think you should inquire about your oncotype score. That is probably why so many do have chemo after clean nodes. I just had chemo with clean nodes. There is a whole topic on this board on Oncotype DX scores. Do ask your doctor for your score .Mine was 27 which was considered high rate of recurrence

I had the 4 TC's . It was doable.I did not have a port. I did not want one and they honored my wish as I only had four TC.s(taxotere/Cytoxin),.That is given evry three weeks.



At the end of this tunnel will be sunshine! It is a sunny day! Dx 9/12/2008, ILC, 1cm, Stage I, Grade 2, 0/3 nodes, ER+/PR-, HER2-
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May 18, 2009 07:06PM Lisa1964 wrote:

Crusader, IDC always means chemo.  Even tho your nodes were clean, the cancer could be hiding somewhere else in the body, waiting to strike later.  IDC is Invasive Ductal Carcinoma, meaning it has "invaded" the body's tissue at some point.  Standard tx for IDC with zero nodes is 4 rounds every 3 wks.  If the nodes are involved, it is 6 rounds.  Good luck.  Chemo is doable.

I attacked and I won! www.JohnnyRebelAcres.com Dx 8/28/2008, IDC, <1cm, Stage IIA, Grade 1, 2/17 nodes, ER+/PR+, HER2+
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May 18, 2009 07:15PM Deb-from-Ohio wrote:

Cancer cells are sneaky, they can be hiding anywhere, sometimes so small imagery doesn't even find them, hence the chemo...it's worth it and doable. I would have it just for my own piece of mind and give myself every shot of it not coming back.

Hugs and prayers

Dx 10/23/2008, IDC, 3cm, Stage IIIA, Grade 2, 1/5 nodes, ER+/PR+, HER2-
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May 18, 2009 07:20PM lisa-e wrote:

LIsa, IDC does not always mean chemo.  The decision regarding chemo is made based upon the cancer's size and agressiveness.   If a cancer has a low chance of recurring, chemo does not offer much in the way of reducing the chances of recurrance.  The Oncotype test is often done to determine the chances of recurrance in node negarive, er  positive cancers.  

I did not have chemo.  I am taking tamoxifen. 

Initial BC dx with dcis & idc after lumpectomy & snb in 6/08. in 8/08 dx with multicentric bc (idc) after mri. had bilat mastecomy in 9/08 w/o reconstruction Dx 5/2008, DCIS, 2cm, Stage 0, Grade 3 Dx 6/2008, IDC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2- Dx 8/2008, IDC, 1cm, Stage I, Grade 1, 0/19 nodes, ER+/PR+, HER2- Surgery Lumpectomy: Right; Lymph node removal: Left, Right, Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left
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May 18, 2009 07:23PM Kaidog wrote:

Hey Aaronali, you and I had our surgeries on the same day, April 30th!  

 Chemo beats a reoccurrence.  You've had SUCH a great attitude so far, so positive, even when you got feverish and sick...  you'll breeze through chemo.  And it might very well save your life.  Chemo can make the difference between winning the war permanently or waging the battle for many years...   If your oncologist is recommending it, go for it.  

Trying to love my chemo curls Dx 4/10/2009, IDC, <1cm, Stage I, Grade 2, 0/4 nodes, ER-/PR-, HER2+
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May 18, 2009 07:30PM aprilgirl1 wrote:

Just wanted to add that I am another node negative IDC gal that is almost done with chemo. I would think that you could have the oncotype DX test done - if you see the New oncotype DX thread under the chemotherapy section  - most of these women are node negative and plenty are doing chemo.  Chemo is doable - as Deb-from-Ohio said - chemo reduces the risk of recurrence (mets) and for me, gives me piece of mind!!!


Dx 11/7/2008, IDC, 1cm, Stage I, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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May 18, 2009 07:35PM ICanDoThis wrote:

Decisions about chemo are getting more complicated, but, right now, not everyone who has IDC gets chemo. The American Cancer Society Standards calls for chemo for all tumors larger than 1 cm, but many oncs feel that these standards are a little out of date, particularly for low-grade tumors (which is what grade 1 is).

Docs look at a combination of your age, the size of the tumor, the status of your nodes, whether or not you are hormone positive, whether or not your tumor is HER +, etc. Here is a link to the information pages from bc.org that will give you an overview of this:


The most recent technology is the oncotype test, which is likely to be what your first oncologist wants to do - it tests the activity of the tumor cells.

I am post-menopausal, my tumor was very low grade, had wide margins, no nodes and I was very ER/PR positive. My oncologist recommended against chemo without doing an oncotype test - said that the chem was more dangerous than the cancer. Got a second opinion, and was told the same thing. But they both recommended hormone therapy.

Personally, I would feel more comfortable with the first oncologist you spoke with, but you may wish to get a 3rd opinion, since you got two different recommendations.

Good luck. You are going through the toughest part of this whole process,

Sue - Proud to be Krista's Mom Dx 12/28/2007, IDC, Left, 1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2- (FISH)
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May 18, 2009 11:48PM sakura73 wrote:

I see from other posts you are 33. For younger women chemo is often recommended because the reality is that we are going to be alive for a long time yet so there are more years in which any rogue cancer cells could re-emerge. YOu intend to live to at least 80, I am sure. That is nearly 50 years in which to risk recurrence, compared to a woman in her sixties who only has to remain recurrence free for 20 or so. 

 I had positive nodes but even without them was still going to have chemo (am 36) as for younger women its results are often very good and better than hormonal treatment, whereas for older women hormonals can sometimes be of more value.

Dx 1/22/2009, ILC, 2cm, Grade 2, 2/17 nodes, ER+/PR+, HER2-
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May 19, 2009 04:57PM - edited May 19, 2009 04:59PM by idaho

The fact is even if you have chemo there is no guarantee that IT won't come back.  In my case the onc. put all my stats in his little computer and told me that chemo only upped my chance of no recurrence by 4 %.  All the side effects from chemo for a 4 % chance-no thanx.  A lot of researchers are finding out that cancer is being over treated.  Just like a few years ago they  figured out that mastectomy was not mandatory breast cancer treatment.  DO get a second opinion, have him put your stats in the computer, and tell you what they are, AND take the oncotype test. Just know that chemo is not mandatory, there are a lot of different factors that play into it.  There is a thread on here called "bottle o' tamoxifen" that has a lot of good info. Tami

There's no place like home......There's no place like home Dx 2/1/2009, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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May 20, 2009 09:11AM angie27 wrote:


I had a lumpectomy and did not have clear margins according to the path report.  Then I decided to have a mastectomy and the path report reveal that I did have clear margins no nodes for me in the two surgeries, and I did have had chemo, because my cancer was aggressive and her2 positive, they decided that I will benefit by 50%. Also my Oncotype score had a lot to do. I am now towards the end of my treatment, and feeling very good, and very happy I did.

"Each day is a gift from God: that's why we call it the present" Dx 12/18/2007, IDC, 4cm, Stage IIA, Grade 2, 0/0 nodes, ER+/PR+, HER2+
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Jun 17, 2009 07:34AM - edited Jun 23, 2009 06:32AM by jotti

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