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Jan 29, 2012 02:09PM
Here's a video of of a breast cancer conference from June 2011 you all might find interesting. You have to register to see it (free). A panel of experts talks about how they would treat a 5 mm, node negative, HER2+, ER negative patient who is < 60 years old (at around 8 min 50 sec (or slide 4) of Module 1).
Of course this isn't my exact case since mine is smaller and ER+ (which are both more positive features), but it is very interesting to listen to, plus, they talk about other case variations. I'm still processing what they had to say. It seems like many of the docs would consider treating if around 5 mm, but most emphasize "it's a conversation with the patient" and some say if she were ER+ it is a more difficult decision, b/c they know Tamox is going to help..so how much more help would chemo be?
When asked about a 3 or 4 mm patient, one doc said it is difficult to know what is the right cut-off. She went on to say that with the 5 mm, some pathologists might tell her it was actually 6 mm, so since this patient is so close to the cut-off, she'd advise chemo/hercep. She never directly answered the 3 to 4 mm question...dang!
Dr. Winer (of Dana Farber) states:
"I think it is a challenging situation. For the patient with a t1A/bordering B ER negative cancer, it is reasonable to consider treatment, but it is by no means something that one always has to do. It is a conversation with the patient. I think for the patient with microinvasive disease, or the patient who has a 2 mm cancer, I think we are treating ourselves and not the patient by administering therapy."
Interesting. This is making me question chemo/Hercep a bit for my case, but the jury is still out in my mind. Hope this helps someone else in the future 'cause this is a tough, tough decision.
Cold caps work! coldcapphotos.shutterfly.com/p... TCH: 4/10 - 6/13/12; 33 rads; BMX w/fat grafting; DX: 7/29/11 @ age 43: Stage 1A on L (3 mm IDC w/ 6 cm DCIS, Gr 2 ER/PR+, HER2+) 0/3 nodes; Stage 0 on R (2 mm DCIS); see bio.