Bordeline case for!

Hi there

I had a lumpectomy 3 weeks ago to remove a 13mm grade 2 hormone receptive tumor as well as a benign lump. The final histology showed that I also had a micro metasis (1mm) in one of the 3 nodes removed. The original biopsy was grade 1 therefore the ‘upgrading’ and the micro metasis make me a borderline case for Chemo (very recently found this out having been told by the surgeon who must have misread the final histology that it was still grade 1 and i would only need radion therapy and hormone therapy).

I am 45 and naturally a person that would mostly err on the side of caution. I feel overwhelmed by the decision as they have also offered me the chance to take pasrt in the OPtima trail for ONCOTYpe DX.

My confusion is in the lymph node involvement. Apparently before central node biospy I would have been classed as node negative.

Has anyone been in this situation (perhaps without the added confusion of the trail)? and what were your feelings/thoughts?

I have to make a decision about the trial  etc by Monday so I would really appreciate some advice.

Many thanks


I was n a similar position 18 months ago. Grade 2, 1.8mm tumour, with a small amount of involvement in the sentinel node, strongly ER +ve.

My consultant was happy to share with me the recurrence and survival rates for me at my age (50 at the time), both with and without chemo. The chemo made a 1 or 2% improvement in survival rates after 10 years. For me I decided that wasn’t enough to outweigh the potential side affects of chemo, so I had rads and lumpectomy, plus tamoxifen.

I would say that if you opt for that you need to be comfortable with your decision, and know that if you do get a recurrence you will always wonder what if… . From your post I wonder if you would really be happier with the belt and braces, know you have thrown everything at it sort of approach?

I am sure other people will be along soon, and I know most make the opposite decision to the one I took.

S far I don’t regret my decision.

I can’t help with the trial decisions am afraid as it wasn’t around at the time.


Hi nannymcd


My results after MX last year were - 3cm, grade 3, 3 lymph nodes removed, one with cancer cells. I was offered chemo but told I didn’t need to have it if I didn’t want to.  I took it, then found out I also had vascular invasion (after chemo session 4) I hadn’t  know before. If you would like to try the ‘predict’ online test before you decide, here is the link:


It will give you a good idea of your survival rates without chemo (as you don’t yet know what regime you would be on). By all means join the trial - it can’t hurt.


Whatever you decide, wishing you all the best.


poemsgalore xx

Hi Nannymcd.  I was in a very similar position to you about 6 weeks ago.  I had a 21mm grade 2 IDC, isolated tumour cells in 1 node plus LVI (ONC didnt tell me that).  ER +ve 8/8.  age 43. My onc told me that chemo would increase my survival rate by 3%, the tamoxifen would be more important for me and the chemo would be the icing on the cake.  I made the decision to have chemo for a few reasons, a significant number of people do not manage to take tamoxifen for the full 5 years and was worried that if i had awful side effects then I would have missed out on chemo and hormones,  I want to be able to look myself in the mirror if I every get a recurrence or secondries and know that I did everything possible to get rid of this first time round.  Isolated turmour cells have only been able to be seen for a few years and not enough information is known about them yet.  When I was deciding whether to have chemo or not I also did a post like this and there was roughly a 50/50 split for those who would or would not have chemo.  In the end it has to be the decision that you are happy with.  I am a third of the way through my chemo and whilst it is not pleasent it is doable.


The trial does sound very interesting.  Im a research nurse and very pro clinical trials.  The test has just been approved by NICE.  One avantage of being in a trial is the close follow up you will get.  I wish you well in making your descion I know I had a few sleepless nights when I was deciding.  Let us know what you decide.xx

Hello Nannymcd


Oncotype DX. is now recommended by NICE, and if this was offered to me 3 months ago when I was diagnosed I would have not hesitate to go for it. Article below is also encouraging.;


Wish you all the best,


Mahsa x