Is chemotherapy likely?

I was diagnosed with Breast cancer back in March. In May I had a bilateral mammoplasty, from which I’m healing nicely.
I had my results appt last week, after which they asked for an urgent CT to check for any spread. Luckily that was negative although they found a thickening of my liver, which I’m having an MRI tomorrow to investigate. I’ve also been told that I’ll have another op soon to remove all my lymph nodes.

Based on my results, what is the likelihood that I’ll need chemo;
Invasive ductal carcinoma - 70mm, 5.5mm and 2mm (Grade 3)
Extensive high grade DCIS
Extensive lumphovascular extension
ER 8/PR 6
HER2 intermediate and FISH not amplified
Node positive 1/2 with extracapsular spread

44 years old, premenopausal.
I’m just trying to prepare myself that I may need chemo after my node clearance.

Many thanks lovely ladies x

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It’s very likely they’ll offer you chemotherapy due to size of tumour

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Thank you for your reply Rosa.
When I was diagnosed it was only 15mm but was very aggressive. Does any one know if that will also change my stage?

If they know it’s in in the lymph nodes it’ll be grade 3. Its only 4 if it’s spread elsewhere in the body.

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Hi @rosa1
I think you are confusing grade with stage. Grade is how different the cells are to normal ones with Grade 3 being the most different / fastest growing. Stage is how far it has spread with 4 being metastatic. So all combinations of grade and stage are technically possible

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They only estimate size at diagnosis so although they’ll give you an estimated stage it’s not definitive. Your definite stage will be based on whatever surgical pathology comes back as. So if your biggest tumor was 70mm with one positive node I believe that’s stage 3. And yes, they will want to do chemo considering the node involvement and size.

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Hi, last year my biopsy result were similar, although my tumour was 2.5 cm(25mm), grade 3, 2 out of 3 sentinel lymph nodes had cancer with extra capsular spread and I had extensive lympho vascular invasion ER8 PR5 and IHC +2 not amplified on ish so classed as her2 negative. My treatment plan lymph node clearance, chemo (3x EC and 3x docataxel) 5 x radiotherapy, iv bisophosphates 6 monthly for 3 years, letrozole for 10 years and 2 years of Abemaciclib. You are younger and I guess premenopausal so you would be given tamoxifen. I was 61 at diagnosis although a fit 61 year old who cycled 30-60 miles a week. Best wishes with your treatment plan, whatever it is.

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Hi @tracey80. Id say from your info that you will need chemo. My tumour is smaller and only grade 2 but I’m fully expecting it. I think if you are pre menopausal and node positive, chemo is usually offered. I’m awaiting 3rd surgery results but i have 2 out of 16 positive nodes and was told that i would probably need chemo. Have you used nhs predict? It will tell you how much benefit you will get from chemo. X

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Thank you all for your replies…
And sorry to hear that so many of you are on/have been on this journey.
Sorry I’m new to this forum and don’t know how to individually reply yet :woman_facepalming:t2: but I’ve done the Predict score. It came up with 12.8% with 3rd gen chemo on the old site. Having seen today that there was a new one I tried it and it came up with 4.2% which I was I thought I would ask.

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If you prepare yourself for having to have chemo, it’ll come less as a shock. I had 6 months of chemo, not pleasant but that means it’s doing what it should. It sounds like you need to get things ordered in your mind, that in itself will help you cope with chemo if it happens. I wish you all the best, one day at a time xx

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Welcome to the forum @tracey80

I’m so sorry to hear about your diagnosis but glad that you have reached out here. As you can see from the replies, this forum is full of kind people and I hope you find the support you are looking for.

For clinical questions like this one, you may find it helpful to post on our Ask Our Nurses board where our specialist breast care nurses will respond.

If you do start chemo, we have monthly chemotherapy starter threads where people share experiences, tips and support each other.

Sending our warmest,
Lucy

Thank you Lucy. I’ve posted on the Ask the Nurses section.
Thank you xx

Hi @tracey80, yes, I’d say chemo very likely. Make sure you get genetic testing if there’s history in your family, because if that comes back positive there are more targeted therapy options these days. My diagnosis was similar to yours. I had chemo (wasn’t too bad) and I’m now on olaparib (instead of abemaciclib) because I’m BRCA2 positive, on top of hormone therapy. Good luck! xx