decisions on treatments

Hello, i am new to this forum and hope someone can helpme.

I live in france and have just had a total single mastectomy.
They found 1 lump of 2cm and took out 14 nodes and found all the nodes clear.
THey now are offerring chemo,radiotherapy,hormone and trials.
I really do not want chemo and not sure of radio, really i just want hormone as they said my cancer was oestragen induced.
i really want to know the risks of not opting for radiotherapy .

Can any one help please

Hi, I also live in France and was diagnosed in Jan last year. Had lump of about 2cm which was triple neg grade 3. Had mx and lymph node clearance, all nodes were clear like you. Then went on to have chemo, radiotherapy and took part in a clinical trial for a year’s treatment of Avastin. I couldn’t have hormone treatment because of being triple neg. I get the feeling in France that they throw everything they can at you. And I personally think that’s a good thing…you should have whatever’s offered if it improves your chances of surviving!!!

Rawlie xx

Do you know the grade of your lump - if it’s 2 or 3 (3 being the most aggressive) that’s probably why they’re recommending chemo and rads. Mine was grade 3 and I had a lot of node involvement. Like Rawlie, my medics wanted to throw everything at it and that was fine by me. If it helps, maybe you could get a second opinion?

Aside from size and nodes there are other prognostic indicators which should inform your decision. What grade was your cancer? Did you have any LVI (lymphovascular invasion)?

There is something called Adjuvant Online which if you Google you will find. Over here most oncologists use it - I don’t know if the French have an equivalent.
It is something you can access yourself online if you are prepared to lie a bit on the initial form (it is supposed to be for medics only but nobody is going to prosecute you if you use it!)
If you know your ER status, HER2 status, size of lump, grade of cancer & number of nodes affected you can access statistical prediction of risk of mortality or recurrence over a 10 year period which is age and health adjusted.
It might help give you a guide as to what percentage gain you will get from each treatment. With early stage, low grade, strongly ER+ cancers women often get as much if not more benefit from hormone therapy as they do from chemo.
Although a mastectomy usually rules out the need for radiotherapy with smaller tumours I decided to go ahead and have 15 doses because I had a lot of LVI which increases risk of regional recurrence.

Your oncologist should really be able to supply you with this data though - she or he is the best person to advise you with regard to your specific prognosis.
Good luck.

Hey there, previous post is absolutely right. Your Oncologist should have run your pathology, age, fitness etc through a computer program and should have an approximate percentage figure of how much having chemotherapy will improve your prognosis. I’m an Oncology Research Nurse, as well as I breast cancer patient, and I’ve seen Doctors give this percentage to the patient in order to help them make up their minds whether or not they want to have chemo. If your cancer is a low grade, then it is very good that none of your lymph nodes are infected and your benefit of having chemo would be lower than someone with a higher grade cancer.

I had my chemo before my Mx and my lump progressed from 3cm at staging to 14cm 5 months later, with 16/23 +ve lymph nodes - so clearly chemo didn’t work for me. I’ve also had local recurrence whilst on Herceptin, so that’s not working for me either. This is just the problem though, there are so many unknowns about cancer, why things work or don’t work.

With the clinical trials, do not feel pressured into doing anything! Even if you go on the trial, then decide to come off - that’s absolutely your right. Phase 3 clinical trials are generally very good though and statistically, patients on clinical trials do better than those who aren’t. But make sure you understand what standard care is and what is being offered to you additional to the trail. Doctors aren’t too good normally at making that distinction, but a good Breast care nurse or research nurse should be available to you.

Please come back and let us know how you get on!