I have just had all my results and been advised to have just Tamoxifen and radiotherapy for my grade 2, 1.5 mm invasive ductal cancer. Sentinel node had micrometastases only and 3 other nodes clear. I have been told that they consider this node negative in terms of treatment. I have been researching all this and know this is a controversial area, there is a tiny benefit from chemo, not much and there are potential serious effects. What advice have others in this postion had?
Hi
I’m sorry that you’re facing this dilemma at all! Its a really difficult decision and ultimately its up to you to weigh the evidence. I had a 1.2 cm, grade 2 IDC, with surrounding intermediate DCIS, & clear sentinel node - not unlike you. I found the online decision making tool ‘Adjuvant!’ to be really useful (don’t be put off by all the blurb when you register) - although recurrence/survival are not the only important outcome measures. Good luck with the process - I’m sure you’ll get lots of feedback from others.
Maggy
You are right, this is very much a grey area - some oncs treat ‘micromets’ as node negative but some err on the side of caution, as mine did, and treat as node positive. However, believe it or not there are different types of micromets and the type and size you have should be in your pathology report. I had to have chemo anyway as I was Grade 3.
There is a separate issue also with micromets - should you have full clearance of all your nodes or not? My surgeon told me before my results were known that if there was a trace of cancer in the nodes I would have to have a second op for full clearance but that didn’t happen - the only nodes removed were from my SNB.
I hope there is another Grade 2 out there who has had to make this decision who can help you more than me, as I have said, I had no choice I had to have chemo. From a personal point of view I am glad that I was overtreated with chemo but do still wonder whether I was undertreated by surgery. Love xxxxx
Hiya, I was Grade 2 (2 lumps,11mm and 20mm) with lots of DCIS and had sentinel biospy with 4 nodes removed. Micromets found in 1 node. I was offered the choice of having further surgery to have a node clearance to ensure there were no other affected nodes, or to have radiotherapy to the underarm or just to leave it. I opted for radiotherapy.
In regards to chemo, I was told when I was 1st diagnosed that I would have to have it due to my young age and the fact that it was multi-focal.
It is so helpful to hear from others who have similar experiences. I am 51 and ER and PgR positive, HER2 negative and they have shown me the Adjuvant Online stuff and I have logged in to it myself. I have done loads of reading and realise now why the treatment of micrometastases in only one node is an area of controversy.
My oncocologist feels chemo not worth the risk for the very small benefit.