micro mets and chemo


I had a grade one 15mm invasive ductal cancer and 8cm dcis removed

SNB showed one node with micro mets

I have been advised to consider the benefits and risks to chemo and decide myself if i an going to have chemo

it was explained that most women choose chemo and many are over treated but cant live with not proceeding

has anyone else with low grade cancer and micro mets able to share what advice they received the rational given and their deciscion

as i cant make one and want to hear your experience

i realise you cant help memake deciscion but would help

love poppy

sorry to ask but what are micro mets, i have ski nodules in the skin of my rec, and a chest wall reccurance, but the nodules in the skin are only around that area of mt reconstruction, no where else, so are thet what you call micro mets.

Hi Poppy, your situation is vastly different from mine but here are two ways you might approach your thinking, depending on how your brain works.

There is a free online tool called NHD predict predict.nhs.uk/predict.shtml into which you can type your data and it will give stats for survival with and without chemo… it’s only an average of course, not a precise calculstion, and it has no guarantees, but with a small (15mm) grade 1 tumour the results it gives won’t spook you. There are other online tools which are more refined but need to be registered for.

The other approach is the ‘if I decide X and it returns will I wish I’d done Y’ which is really what you oncologist is asking you to consider. Chemo is not fun, but it is ‘doable’ and some people will choose it rather than risk the wondering/regretting. Even having chemo is not a guarantee of no return…

This much I do know, whatever choice you make, and how you make it, will be right for you. I wish you well in your deciding and hope that opeopel with more simlar experience are along soon to help you.

Hi Poppy,

I had a similar choice to make, although my tumour was grade 2 it was also 15mm and just my sentinal node was positive with the rest clear.

I used a similar tool you have to register for called Adjuvant (which my oncologist also uses). It gives the survival and recurrance rates with and without chemo (but just a word of warning for anyone thinking about using it; be sure you want to know the results and can deal with them on your own or wait to discuss with your oncologist first).

In my case my tumour was also stongly ER +ve, and it showed a big improvement if I took Tamoxifen, but a very small one for Chemo. The benefits are also different depending on your age.

So in the end I decided the downside to chemo outweighed the benefit and have not had it. My oncoliogist said the choice was totally up to me because it was so borderline.

The only thing I would add is that if you don’t have it you have to be prepared to live with that decision later, and never say “what if”.

There are other people on here who have made a different decision, it is all about what is right for you.


Thamks for your comments

Its just as hard to decide not to have chemo as to have

i know that you just have to take the deciscion that you can live with

Hve gone for oncotype dk as another way of trying to rationalise

thanks everyone

love poppy x

hi Poppy

I was diagnosed with two tumours grade 1, SNB clear but a micromet was found in one of the nodes removed during my mastectomy. Basically they told me I would undergo chemotherapy and radiotherapy due to my age (43) so the choice was not given to me. My tumours were 11mm and 16mm and I had 6cm dcis.

I have just finished my chemotherapy today and due to start rads soon and will start tomoxifin in the next few weeks. Its a long gruelling treatment, but it is doable.

You have to do what’s right for you. Wishing you all the best, whatever choice you make


can i ask, when you had snb, was the node with micromet removed at same time or later operation.

TTM xxx

the node was found during my mastectomy after my SNB (which was clear). I can only presume in my case as I had two tumours the SNB wasn’t correct!. The lymph node with the micromet was removed during my mastectomy

Hope that helps x

Hi Poppy,

I’m in the same position.

I was diagnosed stage 2 Invasive Lobular. Had a wle and snb and one node had a micro met. The margins were not quite clear so had another wle whereby 3 more nodes were taken in with the tissue. So micro met in 1/8 nodes and the tumour was 11 mm. ER positive and I’m 45.

The benfit with chemo has ben expresses as between 2-3%. Given the risks involved with chemo, this brings it down to 1-2%. My team think it is overtreatment. Chemo would be very hard for me to deal with. 6 treatments at 3 weeks each. I have 2 children, single and work fulltime (don’t have a very good sick pay policy).
I’m leaning very heavily towards the don’t have it. If … further down the road, it comes back…which it stillcould with chemo, I’m rationalising my decision with the fact that I will be fitter for not having had chemo and the treatements will be even better in 5-10 years.

I need to decide in the next few days. I am definitely having rads and tamox.

What do you think, does that make sense to you?

Lakeslover, did you have the predict test done to help you decide?

Love to hear your views…

Sassy xx

Hi Sassy

very difficult decision to make, I guess you need to ask how you will be monitored so that any problems will be picked up. I feel exactly the same as you which is aware of the risks of overtreatment with horrible side effects. Do you think chatting it through with your breast care nurse prior to onco visit will help you in case you have more questions

Thinking of you

Poppy x

Hi Sassy and Poppy,

Very difficult decsion to make, but only you can decide. Chat with your BC nurse and see a counsellor if necessary too. Whatever you decide you have to be reasonably happy with, but as you say chemo does not improve your outcome much, and treatment will hopefully get better.

My choice was easy, I have Grade 2 Stage 2 invasive lobular BC, had WLE and x6 LN first, all LN clear, but incomolete excision so MTX 3 weeks later. My chance of recurrence in next 10yrs was 37% with the on line Adjuvant system.Chemo reduced that by 15%, tamoxifen by 11%- no choice- chemo it is, now 2/3rds the way through.

You have to be happy with the decision, so far chemo copable!

Good Luck.


Hi Poppy/Sassy,

I didn’t have the predict test done as I only had a weekend to make up my mind.

My stats were the same as yours, overall maybe a 1-2% improvement, I also have type 2 DM and was worried about what impact any possible of control for that would have as well. My Oncologist was very good, and agreed it was very borderline and it wouldn’t be rash to decide not to have it.

In the end I felt it wasn’t worth it but it is actually quite hard to walk away from any treatment which might give an improvement. I have already questioned myself several times in the middle of the night(4 weeks later) about whether it was the right decision, but each time I go through the numbers again and know I would still do the same thing.

The downside of course is that the recurrance rate is high anyway, so if I get a recurrance or secondaries I will never know whether it was connected to my decision or not. So I have to be prepared to deal with that if it happens.

I don’t want to influence you though as everyone is different.


Hi Lynda,

I am also type 2 Diabetic and am worried about consequences as Bms crazy since all this started. Ate you on metformin if you google metformin and BC there is some interesting research suggesting thats a good thing. Are you taking tamox or anastrole because this reduces recurrence risk too

Not saying you stressed but if you are BC nurse or helpline could prob help allay fears.

My Onc told me that most women notice themselves when things are not right so just get advice as needed

lots of love poppy x


Yes I am on metformin and looked at those studies. Seems interesting. I am on Tam as well which predicted a much better increase in survival rates than chemo (not that it has to be an “either or” of course.

I think the whole thing has been stressful, but I am coming to terms with it now. Off for 3 weeks holiday in the Lake District tomorrow, and then my plan is to try and return to work.


Hi Lynda

have good holiday

hope you can relax and return ready to commence the next stage of the journey which i have seen reffered to as moving on

lots of love Poppy x