Does node involvement always mean chemo?

Diagnosed with breast cancer Recently diagnosed with breast cancer
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Hi, iv recently had a Lumpectomy and node clearance for IDC 3cm grade 3 with 2 nodes involved ER positive Her2 negative. I feel a bit in Limbo at the minute whilst waiting for an oncology appointment. My surgeon wasn’t able to tell me if i required chemotherapy or not , rather that it would be discussed at my oncology appointment.
I assumed as i was grade 3 with 2 nodes involved it would automatically mean chemo but apparently not? Has anyone had a similar diagnosis and what was your treatment plan? Sending lots of love to everyone going through this xxx

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No I had a lymph node in my breast to which the cancer in the lump next to it had metastasised but my cancer was oestrogen and progesterone positive and my result on the oncotype dx test was 14 so low. That meant I didn’t have chemo although this was discussed before the genetic test came back from America. I imagine the oncotyping will help with research eventually as all tissue samples go to the USA for analysis.

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Hi

I am grade 2 Idc with two nodes involved, I’ve just waiting for oncotypedx test result to see if chemo will be beneficial as I sit in the unclear group apparently

Xx

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Hi,
Your cancer sounds similar to mine. I’m in the Uk. I had a 25mm IDC, grade 3, Er8, Pr5 Her 2 negative with 2 lymph nodes involved. I had a lumpectomy, total lymph clearance, chemo(3 EC followed by 3 docataxel). Then 5 fractions of radiotherapy and I’m now on 2 years of adjuvant Abemaciclib, letrozole for 5-10 years and 6 monthly iv bisophosphates for 3 years. I also take Adcal. I didn’t have oncotype score checked on my cancer as my trust presently doesn’t pay for this on the over 60’s, I was 61 at diagnosis, but I have enrolled into the Optima trail and that trial allocated me to chemo. This study is looking at the cost effectiveness of obtaining your oncotype score.

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@Seagulls you made me smile - the thought that a little bit of my boob has had a Christmas trip to :us: even when I couldn’t go with it!

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Thanks so much for your replies. I will ask about an oncotype test when i see the oncologist . i’m 53 amd in the UK xxx

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At your age and with your grade of tumor and node involvement, I imagine you will be getting chemo. They might not want to do an oncotype test as a result.

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I had one node positive.Grade 3 25mm IDC. I had Axillary clearance and 10 days radiotherapy but no chemo. The chemo decision was only made after a low enough score (under 25) on my oncotype dx test, which was sent off to the USA. The waiting for the result of that was probably the worst but of the whole process as it was so unclear as to whether I was to have chemo. I’m 64, and I think age does affect the decision.

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Thanks so much for your replies, much appreciated. My oncologist appointment has come for 22nd January so i’m hoping to get a clearer picture or more waiting for the oncotype test. Either way i’m just keen to get started on whatever treatment is coming next xxx

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Not from my experience after
low ish oncotype x result

Seagulls

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I had two nodes involved and my onco test was 11, so been told just radiotherapy for me.

Wishing you well
Xx

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Hi jcovi

How did your oncology appointment go?

Hope your doing okay

Xx

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Hi, ah thanks for thinking of me! Had my oncology appointment Monday and straight away he mentioned chemotherapy. I asked about the oncotype test and he said cos i havnt gone through the menopause yet it wouldnt be useful? Don’t know why that is? But anyway i’m going to be having 6 rounds of chemotherapy, then radiotherapy. Bit upset today but once iv had a big cry i will feel better and get my head around it. At least I know now xxx

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I’m so sorry jcovi. I know finding out you have to have chemo can be a big shock. If it’s any consolation, I went through it, too, and it wasn’t horrific. Not good mind you but I had the typical reaction so was okay pretty much to my last chemo treatment, felt like dog shit about four weeks afterwards then started feeling like a normal human being. The drugs they give you to help you manage it now are fantastic. Didn’t even throw up until my last session and that was my fault (made myself sick with a laxative). As far as an oncotype test won’t be useful is because of your age. If you are under 50 with node involvement chemo is normally a given and since the oncotype test helps determine whether chemo is beneficial or not there’s no reason to spend the money. They already know it will be beneficial for you.

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