I’ve seen a similar thread on here and now I’m not sure what to do… I have Grade 1 ER+ BC I had 2 lumpectomies and lymph node clearance during second surgery becaue they found 2 nodes had cancer cells in them… the rest were clear. My surgeon said I should discuss chemotherapy with the oncologist because she was not in the DMT. I had a meeting with her and she told me my benefit according the “breast predict” was 2.7% so she wouldn’t normally even be discussing chemo with me because the benefits do not out way the risks. She also made the point that chemo can bring on menopause which can be helpful certainly in my case but I will be taking hormone therapy drugs targeted at my ovaries so this is covered. She was only discussing it with me because she wasn’t at the meeting. If she had been there they wouldn’t even have offered it to me. But as I have had this meeting with her it’s now up to me. I really wish they hadn’t given me the choice…!! I trust the doctors but can’t stop thinking about that additional 2.7% chance it could add to my survival over 15 years. She also said she thought her colleagues had referred to the old version equivalent of “breast predict” which is perhaps why they thought we needed to talk about it. But she says that version is out of date and the new version she referred to was much more reliable.
I really want to make the right decision for me and my family…
Bless you, it’s such an awful decision to make. I was told right the way through that I wouldn’t need chemo, but I ended up having positive nodes and it was decided I would need a chat with the oncologist. I fully expected to be in the same position as you, I thought there would be minimal benefit and I would have to make a decision. Before I went in I had decided that whilst I would be guided by the oncologist, if chemo was an option available to me I would take it on a ‘chuck everything at it’ basis.
Turns out that given my family history etc I would have a 5% benefit from chemo and the oncologist strongly recommended I have it.
I’ve seen women in these forums with lower percentages than me have chemo and I’ve also seen women with the same/higher percentage decide not to have it. It is such a personal choice but you MUST go with what you think is the right decision for you.
Sorry this isn’t much help - I’m sure some of the other ladies/gents will have a view which may be more helpful.
Sorry @loop29 I can’t help with your decision about chemo as my tumour was Grade 1 with no node involvement so chemo definitely not on the cards, the NHS don’t even do Oncotype for Grade 1 apparently. But I was interested in the difference between percentage benefits and being given the choice. 2.7% appears to be a borderline risk/benefit for chemo yet my 0.9% benefit over 15 years of taking endocrine treatment was dismissed with a “we strongly advise you to take it” from the oncologist. I just don’t get it. Also your oncologist appears to have adopted v3 of Predict which has not yet been given NHS approval due to the need for further corroboration of results against international studies. I’m aware of oncologists who won’t even consider v3 and stick to v2.2 (the ‘old’ version presumably) until given wider NHS approval. Personally I think “good on your oncologist” but the disparity in attitudes towards these life-changing decisions is bewildering. Good luck with your decision, it must be extremely difficult.
Hi, I’m sorry to hear of your diagnosis. It must be really difficult for you being given the choice. I remember a short while ago Dr Liz O’Riordan said chemo is only offered if there is a 5% or more benefit.
I was HER2+ and needed chemo to have Herceptin for the size of one of my tumours, I had a primary in both boobs. Some HER2+ tumours are small and the risks outweigh the benefits of chemo and Herceptin so they have surgery and radiotherapy.
This is the predict score link should you wish to look at it more more detail yourself. It has two versions, so you can see the new and old scores for you.
Chemo kills lots of different cells in your body not just the cancer cells and is cardiotoxic, which can cause heart problems.
You could talk through your situation with a BCN nurse
Helpline: 0808 800 6000 (Mon-Fri 9am-4pm; Sat 9am-1pm). Speak to our trained helpline team. No questions are too big or too small.
Ask Our Nurses: You can message our nurses here on the forum, or confidentially. Whatever you prefer
Or you may want to talk it through again with your own Breast Care Nurses.
Okay.
So I had hormone receptive breast cancer; had a mastectomy and then total axilla lymph node clearance. Out of 18 lymph nodes - 4 presented with cancer cells. I had a CT scan to check for spread - all turned out good. My surgeon was pushing for chemo and arranged an appointment with the oncologist. We also went through Predict Breast (newer version has better odds) and I came up as 1% if I had chemo. We had a very long discussion and in the end I’m running with hormone therapy and targeted radiotherapy. It was my decision based purely on the %, no spread and why compromise my healthy immune system with chemo for 16/18 weeks along with all the trauma that goes with it.
It’s a hard decision to make and of course there are no guarantees no matter which route you go down. You can log in to the new version of Predict Breast and have a play - my partner put in lots of scenarios and we both agreed that I was making the right decision.
This link will take you to the newer version once you log in.
Sending love and hugs - and hope you make a decision that you are happy with xxx
In 2011 I was IDC+±. I was 46 years old and had 2 lymph nodes with micromets. The surgeon took out 6. My oncotype was 22. I had a lumpectomy, chemo (TCx4) and rads (33). What I want to share is that it came back a few months ago. Again it is IDC+± in the same breast When I met with my oncologist he said that I wouldn’t have been offered chemo if these same stats were today. He mentioned that Hormonal Therapy is the best bet for ER+ cancer.
So much has changed in treatment over the years. I understand wanting to throw everything at it and although I was tough as nails and handled it well, killing off every cell didn’t really help.
I’ve read and researched and spent hours trying to understand my recurrence. So far they think it is local as they have run an MRI, Bone Scan, CT and PET and they aren’t seeing typical things light up. It’s been 3 months since my mammo and still no surgery either. All the charts and doctors seem to talk about it survival rates. It appears most of us will survive with high percentages, but no one really talked to me about having to go though this again. If the doctor says no, I would throw a party. Wishing you the best :-).
