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All TopicsForum: High Risk of Recurrence or Second Breast Cancer → Topic: Stage 1-Should I worry about recurrence???

Topic: Stage 1-Should I worry about recurrence???

Forum: High Risk of Recurrence or Second Breast Cancer — Managing high recurrence risk of developing a second breast cancer.

Posted on: Jul 13, 2008 01:20PM - edited Jul 13, 2008 01:38PM by tami48

tami48 wrote:

I had bi-lateral mastectomy and Ooph this year.  My Onco says I'm at low risk for cancer recurrence.  I just keep wondering if I really need to be on Arimidex since I'm low risk.  From my understanding they put you on an AI if your tumor is over 1.0, mine was only 1.5.  

I was told that by getting the bm and ooph that I lowered my chances of a recurrence by over 90%.  Sounds pretty good to me.  I'm also BRCA2+.

Has any other Stage 1, Grade 2 ladies had a recurrence that had bi-lateral mastectomy & ooph?  I do worry that my cancer could come back, so I'm asking questions and surfing the internet.

I may sound stupid, but I just wonder......

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Sep 17, 2017 07:54AM letsgogolf wrote:

annwill64 I am on Arimidex and have absolutely no side effects. My sister has been on it for 2 1/2 years with no side effects. I don't think this is unusual.

Oncotype DX = 3. IDC with Lobular Features. Sentinel Node had Micrometastases - Estrogen 100%, Progesterone 99.89%, Ki67= 3.3% Dx 2/14/2017, IDC, Left, 1cm, Stage IB, Grade 1, 0/8 nodes, ER+/PR+, HER2- Surgery 2/27/2017 Lumpectomy: Left Radiation Therapy 4/6/2017 Whole-breast: Lymph nodes Hormonal Therapy 6/1/2017 Arimidex (anastrozole)
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Sep 17, 2017 10:32PM Meow13 wrote:

No side effects, wow. After 2 years of being on anastrozole and exemestane finally getting better from with joint pain and other effects. To me it is so unbelievable how different people react to these drugs. I feel like my health is coming back.

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Sep 18, 2017 08:14AM edwards750 wrote:

We all aware of stats for early stage BC. I am one of those stats. Stage 1b, Grade 1. Small tumor and 11 Oncotype score. 8% chance of recurrence. I'm encouraged but there is no guarantee. Still I worry less as the years go by. I'm 6 years out.

I did take Arimidex and was switched to Tamoxifen because Arimidex attacks the bones and I have borderline osteoporosis. No real side effects except joint pain. Oncologist discharged me and said I could quit taking Tamoxifen. No need to continue on.

I do know people who decided against taking Tamoxifen for various reasons. One in particular didbtcwNt to because she was pre-menopausal and it does throw you into full menopause. Her call, her risk. My sister took Arimidex and now gets shots instead monthly. She couldn't tolerate the side effects. She's one year behind me in DX.

I would talk to my ONC if I was concerned about taking them.

Diane

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Sep 18, 2017 08:30AM Lisey wrote:

Edwards, just to clarify. Tamoxifen does NOT throw you into menopause. I have regular periods and have had no issues there. I've been on it for over a year. No side effects - though my hair is suddenly thinning. I'm not sure that's tamoxifen's fault.


Oncotype =20, ER 95%, PR 5%, ki67= 30%, Mammoprint = Low, Blueprint = Luminal A!!!! TEs= Iron Bra of Death - not worth all the complications for foobs that I'll never feel. Flat and fealess now. Dx 5/11/2016, IDC, Right, 1cm, Stage IA, Grade 2, 0/6 nodes, ER+/PR+, HER2- Surgery 6/1/2016 Lymph node removal: Sentinel Surgery 6/14/2016 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 7/6/2016 Mastectomy: Left, Right Hormonal Therapy 7/14/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Sep 18, 2017 12:08PM Taco1946 wrote:

Farmerlucy - I like your analogy. At 8 months post diagnosis, I find myself thinking about cancer as a chronic disease. I pop my AI along with my cholesterol and blood pressure medicines. All of them should help me stay healthier. None of them guarantee it. I will die of something and frankly, I hope it isn't the senile dementia that my mother had.

I also read in one of the site articles that those of us who take other medication do better with compliance with AI's because it is just added to an already established routine.

Dx 11/22/2016, IDC, Left, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2+ Radiation Therapy 12/29/2016 Balloon-catheter: Breast Chemotherapy 2/3/2017 Taxol (paclitaxel) Targeted Therapy 2/3/2017 Herceptin (trastuzumab) Hormonal Therapy 4/28/2017 Arimidex (anastrozole) Surgery Lumpectomy: Left; Lymph node removal: Sentinel, Underarm/Axillary
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Sep 19, 2017 08:07AM edwards750 wrote:

Lisey - that's what my friend's daughter's Oncologist told her so she refused to take it. It doesn't apply to me since I've already been through it.

Diane

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Sep 19, 2017 08:12AM edwards750 wrote:

Read the articles about Tamoxifen and premature menopause. It definitely can do that because it is an estrogen blocker. Not saying every woman will but it does happen.

Diane

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Sep 19, 2017 08:34AM pupmom wrote:

DIanne, this is literally the first time I have heard about that being an SE of tamoxifen. Do you have any literature you can link which discusses this? If your friend's daughter needs tam and refused to take it because of that extremely unlikely SE, she was very foolish. I would also question the competence of her doctor.

Life is what happens while we're making other plans. Dx 10/18/2011, IDC, 1cm, Stage IIA, Grade 1, 2/21 nodes, ER+/PR+, HER2-
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Sep 19, 2017 12:16PM ReginaZ wrote:

I've been on the generic Arimidex for 6 months now, and no real side effects. It is the most effective treatment for those of us who are highly ER+. However, if I do develop unbearable side effects in the future, I won't feel too bad stopping it because my risk of recurrence is low either way

We are not human beings having a spiritual experience, we are spiritual beings having a human experience Dx 2/2/2017, IDC, Right, 1cm, Stage IA, Grade 2, 1/7 nodes, ER+/PR+, HER2- Surgery 2/20/2017 Lumpectomy: Right; Lymph node removal: Sentinel, Underarm/Axillary Hormonal Therapy 3/23/2017 Arimidex (anastrozole) Radiation Therapy 4/13/2017 Whole-breast: Breast
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Sep 19, 2017 01:04PM mustlovepoodles wrote:

annwiil, keep in mind that the people who post here are a minority of those who have breast cancer. Those who post are generally either questioning or have some issues.

I've been on letrozole for 18 months months. Other than joint pain and aches, I haven't had much trouble. No hair thinning, no weight gain. In fact, I've lost 20-lbs! I have arthitis anyway, so it's hard to tell how much joint pain is a side efect, but it's not debilitating. My sister has taken Arimidex for 5 years and has zero SEs.

I have PALB2 and Chek2 mutations, which puts me right in the middle of BRCA2 risk. I wouldn't even dream of not taking my AI!

Oncotype 23. Positive for PALB2 & Chek2 gene mutations. My breasts are trying to kill me! Dx 7/20/2015, DCIS/IDC, Right, 1cm, Stage IA, Grade 3, 0/2 nodes, ER+/PR-, HER2- Surgery 8/19/2015 Lumpectomy Surgery 9/2/2015 Lumpectomy: Right Chemotherapy 10/19/2015 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 2/3/2016 Prophylactic mastectomy: Left, Right Surgery 10/18/2016 Hormonal Therapy Femara (letrozole) Surgery
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Sep 19, 2017 08:34PM exbrnxgrl wrote:

I am in an entirely different situation than those who are early stage, but wanted to comment on se's of AI's. Listed se's and se's that you read about on message boards can all happen, but it's important to remember that those who no or minimal se's are usually not posting about that on support forums. I have been NED on Arimidex and now Femara for 6 years. Being stage IV, I will not consider stopping but more importantly, though I have some joint and bone pain, my QOL has not been diminished. I work full time, walk my dogs, play with my grandchildren and even climbed the Harbour Bridge in Sydney a few years ago. Please remember that those who are fine on these drugs rarely have threads/posts about it !

Bilateral mx 9/7/11 with one step ns reconstruction. As of 11/21/11, 2cm met to upper left femur Dx 7/8/2011, IDC, Left, 4cm, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Surgery 9/7/2011 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right) Dx 11/2011, IDC, Left, 4cm, Stage IV, Grade 1, 1/15 nodes, mets, ER+/PR+, HER2- Hormonal Therapy 11/21/2011 Arimidex (anastrozole) Radiation Therapy 11/21/2011 Bone Hormonal Therapy 6/19/2014 Femara (letrozole)
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Sep 20, 2017 08:36PM Meow13 wrote:

My side effects were cumulative to point I felt unable to get out of bed from joint pain. My doctor said I should have told him how bad things were getting. I hate to complain I felt confident the anastrozole was protecting me from cancer recurrence. It was exemestane that caused severe dry eye. The thought of losing my eye sight scared the crap out of me. Sooooo happy not to be on meds anymore.

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Sep 20, 2017 08:42PM marijen wrote:

Meow did your pain subside after you got off? And if it did how long did it take? Pls.


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Sep 20, 2017 10:35PM Meow13 wrote:

oh yes much much better. I still have some arthritis.

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Sep 22, 2017 07:32PM - edited Oct 15, 2017 09:47PM by marijen

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Sep 24, 2017 07:50AM Corinne6 wrote:

No. Worrying won't help. I was in stage 2 and am 9 yrs out. Most cancers are cured in stage one and 2

Have not I commanded thee? Be strong and of good courage: be not afraid,neither be dismayed: for the Lord thy God is with thee whithersoever thou goest. Joshua1:9 Dx 7/2008, IDC, Left, 1cm, Stage IIA, Grade 3, 2/15 nodes, mets, ER+/PR-, HER2+ (FISH)
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Oct 26, 2017 12:52PM - edited Oct 26, 2017 12:55PM by marijen

Study reveals link between cancer relapse and body's immune system

October 17, 2017

Results from a new study conducted at the Institute of Cancer Research, London, suggests cancer cells that remain in the body after treatment, utilize the immune system of the body to wake themselves up and boost their growth.

Cancer cells can lay dormant in the body long after treatment, then turn deadly after a number of years. The aim of the study was to understand this process.

It was found that the immune system becomes unable to keep the cancer cells under control, leading to a relapse. According to the study, immunotherapy could be utilized for the effective prevention of the recurrence by putting the immune response of the body back on track.

In order to analyze the nature and behavior of the cancer cells before initial treatment, after treatment and during relapse, the researchers examined the immune responses in mice.

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Saved from URL: www.news-medical.net/news/2017... mune-system.aspx

Study reveals link between cancer relapse and body's immune system

Generally, in response to infection or trauma, the immune cells release signals to trigger inflammation. In some situations, this might help the immune system in killing the cancer cells. However, the study indicated that the cancer cells which survived the treatment undermined these signals, resulting in their aggressive growth during recurrence.

Also, it was found that immunotherapies targeting this response might either prevent or delay cancer relapse in mice; this is expected to be effective in patients at risk of recurrence.

The findings of the study indicated that TNF­alpha — a chemical signal — transforms itself from an anti­tumor agent to a signal that promotes the relapse of cancer. The functions of the natural killer immune cells will also be suppressed due to the influence of these resistant cells, resulting in the uninterrupted growth of the relapsing cancer cells.

Also, it was found that PD­L1 which is present in high levels on the surface of these resistant cancer cells interacts with PD­1 on immune cells named as T cells asking them not to attack. For extremely successful immune checkpoint inhibitor drugs, PD­1 is the target and it was proved that these treatments are capable of delaying or preventing relapse in mice.

Professor Kevin Harrington, Professor of Biological Cancer Therapies at The Institute of Cancer Research, a co­author of the study said: "It is becoming increasing clear that the immune system is at the core of the puzzle of how we can treat cancer more effectively."

According to him, the study aids in explaining why immune system can be effective against cancer cells in some cases and not in others. Understanding the complete mechanism behind this behavior of the immune system can help in developing novel treatment options to prevent cancer relapse, he added.

Source:

eurekalert.org/pub_releases/2017­10/iocr­crl101317.php

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Oct 28, 2017 05:25PM swg wrote:

I am stage 1, grade 2. I have 2 tumors but according to research, this doesn't affect my survivability or prognosis. I'm preparing to have a mastectomy. Not sure if unilateral or bilateral. I don't yet know if any lymph nodes are affected. No oncotype known yet.

I think it's natural to worry about recurrence, no matter what stage you're at.

Something that's making me feel better is doing as much research as I can on what *I* can control to try to prevent it. Such as, diet..exercise..etc. Flaxseeds, for ex, actually have a preventative effect, as shown in studies. And for ER+/PR+ cancer, eating 5 fruits and veggies per day and getting 30 min of physical activity 6 times a week helps your survival rate.

Hope this helps!

Dx 9/11/17. IDC grade 2, stage 1. 1.2cm. in right breast. ER+/PR+, HER2- 2nd tumor in right breast found 10/22/17. Dx 9/11/2017, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (IHC) Dx 10/23/2017, DCIS/IDC, Right, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2- Surgery 11/28/2017 Mastectomy; Reconstruction (right): Tissue expander placement Hormonal Therapy
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Oct 28, 2017 05:27PM swg wrote:

Yeah..it's my understanding all Tamoxifen does is block your estrogen from fueling the cancer cells. It doesn't shut off estrogen production, so makes no sense that it would make someone hit menopause. Maybe this woman hit menopause because it was her time.

Dx 9/11/17. IDC grade 2, stage 1. 1.2cm. in right breast. ER+/PR+, HER2- 2nd tumor in right breast found 10/22/17. Dx 9/11/2017, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (IHC) Dx 10/23/2017, DCIS/IDC, Right, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2- Surgery 11/28/2017 Mastectomy; Reconstruction (right): Tissue expander placement Hormonal Therapy
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Oct 28, 2017 05:29PM swg wrote:

Taco ,my dad died of Alzheimers 2 years ago..I feel you on that. It's not like cancer is such a great death, but I SURE don't want to get Alzheimers :(

Maybe we will live long enough to see a cure for both cancer AND Alzheimers.

Dx 9/11/17. IDC grade 2, stage 1. 1.2cm. in right breast. ER+/PR+, HER2- 2nd tumor in right breast found 10/22/17. Dx 9/11/2017, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (IHC) Dx 10/23/2017, DCIS/IDC, Right, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2- Surgery 11/28/2017 Mastectomy; Reconstruction (right): Tissue expander placement Hormonal Therapy
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Nov 2, 2017 01:03PM marijen wrote:

Get your MRI when offered.

Majority of women at higher risk for breast cancer decline MRI screenings, study finds

October 26, 2017

Some women, because of genetic predisposition, personal, or family history, have a higher than average lifetime risk of developing breast cancer. For those women, earlier magnetic resonance imaging (MRI) is recommended for cancer screening.

But according to new findings presented at the American College of Surgeons Clinical Congress 2017, the vast majority of women in one health system who are at higher risk of breast cancer choose not to get MRI screenings, even when the service was available to them at no cost.

"The military health system is an equal access, no cost system. This system allows us to study how well we are doing in terms of truly adhering to the current recommended guidelines for screening of breast cancer," said lead study author Vance Sohn, MD, a surgical oncologist at Madigan Army Medical Center, Tacoma, Wash.

For the study, investigators from Madigan Army Medical Center analyzed data on 1,057 women who had a 20 percent or greater lifetime risk of developing breast cancer. The screenings were offered based on their high­risk status, and not because of mammography results. Between 2015 and 2016, these women were offered MRI screenings. The aim of this analysis was to assess whether these higher risk women actually got the imaging test. Overall, the study showed that only 23 percent (247 women) underwent MRI screening.

Further, when results were expressed in quartiles, researchers found that just 15 percent of women with a 20 to 24 percent lifetime risk of breast cancer had an MRI; 24 percent of those with a 25 to 29 percent risk got the imaging test; 36 percent of women with a 30 to 39 percent risk sought an MRI; and only half of the women with more than a 40 percent lifetime risk of developing breast cancer chose to get this recommended screening.

"In the interest of helping more women be screened earlier for breast cancer, we were intrigued about what this preliminary study identified­­that 85 percent of women with a 20 to 24 percent lifetime risk still did not pursue high risk

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Saved from URL: www.news-medical.net/news/2017... creenings-study-finds.aspx

Majority of women at higher risk for breast cancer decline MRI screenings, study finds

of women with a 20 to 24 percent lifetime risk still did not pursue high risk surveillance," Dr. Sohn reported. "Ultimately, the question we are really trying to answer is why women at high risk for breast cancer are declining MRI screening. That issue is the next phase of this study."

Dr. Sohn and his team plan further research to find out why, on an individual basis, women are declining this cancer check. Is it confusion about the screening tool itself and its safety? Are they afraid of what the test might reveal?

"If we understand the reason behind this circumstance, it will help us better target those who would benefit from this imaging modality so we could provide clear explanations about the test," Dr. Sohn said. "The general sense is that patients are just too busy, but discovering the reason will be a very important piece to this puzzle."

Although this was a military health system study, Dr. Sohn, said he does not think their findings are unique to the military. "In fact, I imagine our compliance rate is even higher than most. Within the civilian health care system, there are fiscal implications such as the cost of the MRI and future health insurance implications, that we are controlling for," he said.

In general, when it comes to breast cancer screening more is not necessarily better. In the past, the misuse of screening MRIs has created much anxiety in women, leading clinicians to perform further testing for tiny spots that turn out to be benign. To target patients for appropriate testing, clinicians and patients alike need a full understanding of the pros and cons of MRI screening. Clinicians then can develop personalized screening plans.

What the study does highlight is that the appropriate application of this imaging technology is very important, Dr. Sohn said.

"So maybe the 20 to 24 percent lifetime risk isn't really appropriate, maybe it should be even higher than what the organizations are recommending. In other words, what is the appropriate cutoff?

Ultimately, that is really what we are trying to decipher," said he concluded. Source:

www.facs.org/media/press­releases/2017/sohn

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