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If you are stage 1, ER/PR+, HER- and need chemo, can you tell me the reason?

BioAdoptMom3
Posts: 43
Joined: Mar 2011

I will see my medical oncologist for the first time in about 2 weeks. My BS has prepared us for the possibility that chemo will be suggested. My diagnosis is IDC, stage 1, grade 3 and the tumor was a little over 1 cm. My 7 nodes removed were clean, however my margins weren't clear and I had a re-excision last week, making them now clear. I am ER/PR+ and HER2-. I will have radiation and am planning on hormone therapy in the near future, but his suggestion of POSSIBLE chemo took me a bit by surprise. So if your stats are similar or the same and you had or will have chemo and don't mind sharing, can you tell me why?

Thanks!

Nancy

Katmy
Posts: 93
Joined: Mar 2011

My cancer diagnosis is similar. I am small chested so we were advised to have a radical mastectomy. I did.
Because my margins were not clear, I immediately went to radiation.
Now, I am doing 4 rounds of Taxotere and Cytoxin. It increases my odds of cure by a small margin, but one worth taking. All medical people advising me said, "you get this one chance at a cure. If you don't do chemo now and the cancer shows up else where, the chemo may be much less successful. Better to prevent matastisis." So I followed their advice.

DebbyM's picture
DebbyM
Posts: 3294
Joined: Oct 2009

I was Stage 1 and didn't have chemo. The %, according to the stats, was that chemo would only help about 2% and that was not worth it to me. You need to take your advice of your oncologist and decide for yourself.

Good luck!

TraciInLA's picture
TraciInLA
Posts: 1838
Joined: Jul 2009

Welcome, Nancy -

I was diagnosed with invasive ductal in one breast, invasive lobular in the other, ER+/PR+/HER2-, stage 1, grade 2. I had 4 tumors total, but very tiny -- none larger than 2 mm. Negative nodes. I had bilateral lumpectomies, followed by chemo, then radiation, and am now on Tamoxifen.

Both my oncologist and a 2nd oncologist who specializes in breast cancer were very much on the fence about whether or not I "needed" to do chemo. My oncologist ran a computer simulation that estimated that chemo would decrease my chances of recurrence by 3-4%, and that was enough for me -- I said, sign me up.

Many women have the OncotypeDX test done, which estimates how effective chemo would be on your particular tumor. I was offered the Oncotype test, but refused it, because I had already made the decision that I wanted to do chemo.

For me the main reason for my decision was that I couldn't live with myself if I didn't do chemo, the cancer returned later, and I was left thinking, what if I'd done chemo? Hitting it with everything I could was the right decision for my own peace of mind.

Don't know if that helps, but do keep us posted on your oncologist visit?

Traci

disneyfan2008
Posts: 5299
Joined: Oct 2010

other then treatments... ER+/PR+/HER2-, stage 1, grade 2. I had 4 tumors total, but very tiny -- none larger than 2 mm. Negative nodes I have never heard any of this with my treatment just over 3 yrs ago...

I just am told labs good now etc..no clue what it was when I started..margins etc...

I should be more informed I GUESS after reading so many who know exact details...

Denise

TraciInLA's picture
TraciInLA
Posts: 1838
Joined: Jul 2009

Denise -

Most of this information is found on the pathology reports that are issued after biopsies and after surgery. I felt it was very important for me to have copies of my own pathology reports, so I always asked for them from my surgeon or oncologist.

ER/PR/HER2 status and grade are on the pathology report of the biopsy(ies) used to diagnose cancer.

Stage, tumor size, margins, and lymph node positive/negative are on the pathology report following surgery.

My various doctors discussed these with me along the way; however, I just felt more comfortable having copies of my own reports, to refer to later.

Traci

PinkPearl's picture
PinkPearl
Posts: 280
Joined: Oct 2010

I am Stage 1, ER+PR-Her2- and tumor was about 1 cm. I had 4 nodes removed and margins were clear. However the tumor was never seen on a mammogram and just barely on the ultrasound and I have a poor family history. Therefore I elected a bilateral and my breast surgeon agreed. I did not expect any radiation (due to having the mastectomies at that early point) and thought chemo would be questionable. After all, mamy are overtreated because we don't know where we as individuals fall in the statistical range ---ie.are we in the 80% who don't have a return without any treatment? or the other 20% who do? However my oncologist did have the Oncotype DX run and it came back with a very high score for reoccurance and so I am having chemo and am on #3 or 4 rounds of TC. Not everyone is a good candidate for that test because it is usually for early stage cancers where no one quite knows how to read the cancer. For me, my cancer's statistics make it looks calm and sort of easy to beat but internally there is something in it that makes it aggresssive. I think you might want to have that run unless your doctor explains some other reasons to you.

CypressCynthia's picture
CypressCynthia
Posts: 3930
Joined: Oct 2009

My sister's stats were the same as yours and she did have chemo, but it was her choice. It is possibly the grade 3 that is worrying your onc as this means that the cells look less like normal cells and multiply faster. But, when in doubt, it is your right to seek out a second opinion.

See:
Tumor Grade

Boppy_of_5's picture
Boppy_of_5
Posts: 1138
Joined: Apr 2010

I was dx'd with stage 1 grade 1 IDC ER/PR+ HER- I had a lumpectomy, 3 nodes removed all clear and clear margins.Tumor was right at 1 cm. I did 4 rounds of Cytoxan and Taxotere, followed by 30 rads and I am now on Tamoxifen. My Onc. recommended I do chemo because of my age, I turned 49 right after dx. They kept saying because you are so young. I went with the chemo because I wanted to know I had done everything I could possibly do to beat the beast. God Bless
(((hugs))) Janice

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carkris
Posts: 4520
Joined: Aug 2009

yes I was thinking the same thing as CC

Double Whammy's picture
Double Whammy
Posts: 2267
Joined: Jun 2010

My BC was Stage 1, Grade 2, ER/PR+, Her2 -. We did the oncotype test and that made the decision for me. I had already decided I would do chemo unless the oncotype # was really low. I just wanted to give it everything I could. Turned out I didn't have a choice (well, of course, I could have said no).

Suzanne

BioAdoptMom3
Posts: 43
Joined: Mar 2011

Thank you so much for your helpful and encouraging comments regarding chemo for us stage 1 sisters! I am leaning towards taking if my onco thinks it will make even a small difference in long term survival (of course not if the potential side effects outweigh the benefits). I do not want this beast to return in any form and will do anything I can to prevent that!

I am so glad I found this board. Everyone here seems so warm and supportive.

Praying for everyone here!

Nancy

Susiestn
Posts: 13
Joined: Mar 2011

Same stats and onc score of 17. I'm 45 years old and have 9 year old twin girls. I start chemo (my decision) next week. Couldn't live wondering everyday if I did enough to make sure this doesn't return! I'm scared to death about what's ahead but I don't ever want to say "if I only had..." Good luck to you and I know how hard a decision this is!

JuJuBeez's picture
JuJuBeez
Posts: 332
Joined: Apr 2010

I was Stage 1, grade 2, 1cm, IDC, clean nodes, clean margins, ER+ PR+. My oncotype score was 12. My onco said he didn't think I needed to have chemo because it would only improve my prognosis by a couple of percentage points. I had partial-breast radiation 2x/day for 5 days. I've been on Tamoxifen since August.

Janet T.
Posts: 4
Joined: Mar 2011

My oncotype score was 11 but I was also told about the Taxotere/cytoxin plan. I wish the stats showed a larger benefit from chemo. It makes the decision so difficult. I just found out my score today and am trying to decide what to do as my oncologist told me either way is the "right" decision. Ack! I'm 43, have 3 kids under 11 so definitely want to be here for them. However, I hate to put our entire family through this if chemo isn't warranted. How do you know if it's over treating or not?

BioAdoptMom3
Posts: 43
Joined: Mar 2011

Thank you for your additional comments. Your sharing is helping me to be more prepared for the possibility of chemo, and reading this board has relieved my mind quite a bit. It certainly doesn't sound fun and I know I'd rather not, but at least it sounds doable and I want to do everything I can to prevent a recurrance!

Nancy

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csr771
Posts: 112
Joined: Mar 2011

I was stage 1, no node involvment, IDC 9cm, non-aggressive, hormone receptive cancer, DX Nov, 2010. I had a mastectomy in January and immedate recostruction. I go the results of the oncotype DX test last week. My onco would have liked the score to be around 18, but it was 22. I have a 10% chance of recurrence in the next 10 years and chemo would have only reduced the percentage of recurrence by 1 or 2%. My breast surgeon, prior to my seeing the onco, had said that I would more than likely need chemo, but the Onco said that if I was one of hs family members he wouldn't recommend it. My options would have been chemo plus Arimidex or Arimidex only. I am on Arimidex only.

VickiSam's picture
VickiSam
Posts: 8228
Joined: Aug 2009

,,,,,

BioAdoptMom
Posts: 358
Joined: Mar 2011

Thank you all so much for your additional comments, advice and wisdom! I am pretty sure based on all this info, plus what I have read, that if the onco tells me on Wednesday that chemo will increase my long term survival rates by at least 3 percentage points I will go for it! I have an 11 y/o DD and two young adult sons and would love to increase my chances of being around for college graduations, weddings and grandchildren!

Thanks again!

Nancy

Angie2U's picture
Angie2U
Posts: 2993
Joined: Sep 2009

Good luck with your appointment Nancy and good luck with chemo if you decide to do it, based on your oncologist's opinion.

Hugs, Angie

bethsbaby's picture
bethsbaby
Posts: 5
Joined: Apr 2011

I am a 47yr and pre-menopausal. I was diagnosed 1/27/11 with ILC, further testing revealed multiple locations in the same breast of invasive lobular carcinoma. Tumors were 1.2cm, .8cm, and .5cm. I had 0/7 nodes positive. I am BRAC 1&2-, Oncotypedx score 25. I had a bilateral mastectomy with reconstruction started on 3/2. Today was my first appt. with the Oncologist. His recommendation is 4 doses of TC every 3 weeks, followed by Tamoxifen for 5 years, based on the fact that together the tumors represented 2.5 cm of cancer. He stated that Oncotype score just solidified his feelings that I would benefit from chemo. I had really hoped not to need chemo. Although I want to do everything I can to make sure this doesn't come back, I am afraid. My mother had breast cancer, which was much more invasive than mine. She participated in a clinical trial in 1994, and recieved high doses of AC. Unfortunately she developed AML,(leukemia) 2 yrs after her chemo treatment. I know first hand that chemo has risks, but I am hoping to decide what to do this weekend.

Asmi637
Posts: 8
Joined: Dec 2012

Hi, my mom was just recently diagnosed with Stage 1 breast cancer grade 3, 1.3cm tumor in her breast with ER/PR+ HER- and she is 54 years old. I was wondering if she would be needing chemo? I dont know the oncotest yet because her surgery has not been done yet so we also dont know if any of the nodes are affected or not but if they are all clear, do you suggest chemo? You have been through it and wanted to know what you decided to do? Just trying to figure out everything for her.

Asmi637
Posts: 8
Joined: Dec 2012

Hi, my mom was just recently diagnosed with Stage 1 breast cancer grade 3, 1.3cm tumor in her breast with ER/PR+ HER- and she is 54 years old. I was wondering if she would be needing chemo? I dont know the oncotest yet because her surgery has not been done yet so we also dont know if any of the nodes are affected or not but if they are all clear, do you suggest chemo? You have been through it and wanted to know what you decided to do? Just trying to figure out everything for her.

Asmi637
Posts: 8
Joined: Dec 2012

Hi, my mom was just recently diagnosed with Stage 1 breast cancer grade 3, 1.3cm tumor in her breast with ER/PR+ HER- and she is 54 years old. I was wondering if she would be needing chemo? I dont know the oncotest yet because her surgery has not been done yet so we also dont know if any of the nodes are affected or not but if they are all clear, do you suggest chemo? You have been through it and wanted to know what you decided to do? Just trying to figure out everything for her.

Asmi637
Posts: 8
Joined: Dec 2012

Hi, my mom was just recently diagnosed with Stage 1 breast cancer grade 3, 1.3cm tumor in her breast with ER/PR+ HER- and she is 54 years old. I was wondering if she would be needing chemo? I dont know the oncotest yet because her surgery has not been done yet so we also dont know if any of the nodes are affected or not but if they are all clear, do you suggest chemo? You have been through it and wanted to know what you decided to do? Just trying to figure out everything for her.

Asmi637
Posts: 8
Joined: Dec 2012

Hi, my mom was just recently diagnosed with Stage 1 breast cancer grade 3, 1.3cm tumor in her breast with ER/PR+ HER- and she is 54 years old. I was wondering if she would be needing chemo? I dont know the oncotest yet because her surgery has not been done yet so we also dont know if any of the nodes are affected or not but if they are all clear, do you suggest chemo? You have been through it and wanted to know what you decided to do? Just trying to figure out everything for her.

MsGebby's picture
MsGebby
Posts: 659
Joined: Oct 2011

I am stage 2, IDC/DCIS, 3cm tumor, no nodes involved, grade 2, ER+/PR+ HER2-. I had a re excision to get clean margins. The very first day I met with my oncologist, she wanted me to start chemo right away. I cannot tell you how much that made my heart skip. I didn't want to go that route and asked for Oncotype DX. The test came back with a number 4! My onco couldn't believe it. She thought that the Ki67 and p53 scores were too high as well as the tumor being so large and thought that there was no way I could side step this treatment.

Thank goodness for Oncotype DX. I did 38 rounds of radiation and now take Tamoxifen. I am told I will be taking it for 10 years. I guess this is becoming the new norm.

Please make sure to ask about this test. It really does tell the whole story.

xoxo
Mary

Asmi637
Posts: 8
Joined: Dec 2012

This is the exact test we are going to be waiting for after the surgery. Then we can Make our decision. Thanks for sharing with me. How long did your radiation take?

Ctine70's picture
Ctine70
Posts: 150
Joined: Sep 2012

I too had IDC stage 1 grade 2 tumor 1.3 nodes clear and margins clear. My oncologist said that due to my age 42 chemo was needed ( was also hormone receptive positive) she said that there were a few reasons...one was that you never know if some of the cancer did escape and could be somewhere else. Two because I needed to be put into menopause since my cancer was hormone feed and lastly because of my age it increased my survival rate. I just finished 6 rounds of T/C and will start 35 rounds of radiation in January
Hope this helps, good luck to you

Hugs
Christine

Asmi637
Posts: 8
Joined: Dec 2012

My mom had the mastectomy  and her results said that she had a 1.5 cm plus another small lump which was smaller than the 1.5 which now puts her in grade 1B Stage 3 Breast Cancer 

she also had a Microscopic cancer in one of her lymph node which they removed 8 total Lymph nodes.  Now we are confused on what our next step would be.  We have requested the Oncotype test but now im thinking if there was a resaon I did that because I should have her do the rounds of chemo?  Can anyone help to decide and what they have done if they were in the same situation?  We are so confused now.  

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