What is the likelyhood of needing chemo?

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1

Hello again
Another post from me…

I am 38, had a mastectomy 4 weeks ago, and all my lympth nodes removed after the discovery of tumour cells in one node.
My tumour was 4cm long i am told.

What is the chance that i will also be offered chemo?
Do i have to have it?

Thanks.
Naz

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Hi NAZ
I’d like to know the answer to that question too.
I have DCIS- removed but very small. However they found cancer in my sentinel Lymph node. I had axillary clearance last week. I am hoping it hasn’t spread any further and that I only have to have radio and hormone therapy. Waiting for thr results is hell- my surgeon is on holiday till next week!
I hope you get an answer soon
XM

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hiya and welcome.

Its not so much the size as the grade.

Grade 1 is the lowest and grade 3 is the highest. Most young women have grade 3 BC . what have they said to you?

If cancer is in your nodes they advice chemo too to make sure any stray cells are killed.

I had clear lymph nodes and a 2.0mm grade 3 BC and i was told i needed chemo for certain.

If you oncologist advices you to have chemo it is wise to follow their advice if chemo will improve your prognosis. They tend to use a calculator style program. Chemo, radio and tamoxifen increased my prognosis by 9%- worth it for me!

Good luck.

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Hi

I think if any amount of nodes are affected then they usually give chemo, especially if it is over 2cm. A 4cm lump even with no nodes would probably benefit from chemo.

The other factor is whether it is hormone positive or not.

I was told I didnt need chemo despite being aged 34 and grade 3. This is because I had a small lump, no nodes and was 8/8 for both hormones, meaning that zoladex and tamoxifen would do the same for me as chemo would have.

xx

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Thanks for your replies.
Mine is definitely hormone receptive, so i am hoping that is a good thing.
I guess i will wait and see what the oncologist says when i see her.

Thanks again.

xx

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I was told that due to my age (44 at dx) I would almost certainly be offered chemo irrespective of the surgery results. As it turned out, I was grade 3 with 3/16 nodes, so chemo was vey definitely needed.

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Hi Naz
Hormone receptive means that the cancer cells react more quickly when they meet hormone cells (I think), so I am afraid it is not really a good thing.

I suspect with a mastectomy and node involvement and hormone receptive, it is highly likely they will recommend chemo.

Do you feel strongly about not wanting it?

I want EVERYTHING to be thrown at it to reduce the chances of it coming back. I see it as just a short period of discomfort in my life, but a much greater chance of seeing much more of life!!

Take care
Flora xxx

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Just to comment on the hormone receptor question. Hormone positive means that the tumour grows in response to the female hormones oestrogen and / or progesterone.
It is actually a good thing because there are drugs like tamoxifen and aromatase inhibitors which can be taken to block oestrogen or prevent you making it.
Hormone positive cancers have better survival rates than hormone negative ones.
The down side for younger women is that there are implications round fertility and pregnancy.

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I agree with Judie. Hormone positive means there are more drug options for treating it.

Ann

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Hi,I had 1.7 cm tumour and cancer in 1 node and I had chemo.Oncologist said this was because of my age (45)and the possitive node.Mine was also er+ and I was told that this was good(no cancer is good is it)because I could take tamoxifen for extra protection . I think that er/pr- cancers respond very well to chemo.

best wishes Mel x

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Thanks once again for your replies.
I did think that the er + was a good thing from what the breast nurse told me.
With regard to the chemo, i guess i am scared…not sure what of, as i know it is the best chance of stamping this thing ou…fear of the unknown i guess…

Thanks again.
Naz x

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Hi Naz and all the other lovely ladies - I have been reading this thread with interest. My lump is over 5cm and I have been told I have DCIS/IDC and ILC. I am 48 years old and my mastectomy is scheduled for thursday 29/10/09 (so not too long to wait). My onc told me that it is er+ and he MAY give me a few blasts of chemo just to be sure due my age etc., but could not confirm if my lymph nodes are ok until after surgery but he was optimistic that the drugs would be enough. The thought of chemo does scare me, but then so does bc and surgery and the future and … the whole lot of it. Just thought I would share my experience with you all - won’t know if i need chemo until mid-nov and I know this forum will get me through the waiting time.

Courage and hugs to all!

Jean

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Hi

Couldnt help but imput.

I was 22 when DX and was told that i would definately have chemeo, after looking at tumor, was told that 9mm grade 1-2 and no node involvement, I never had to have chemo and that wasnt my choice, chemo would have probably left me worse off apparantly, just tamoxifen and zoladex, nearly 2 yrs down the line and im fine, so i dont think that some go on age, more the type of cancer grade etc.

Emily xxx

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Jean

Sorry you are having to go through this. I just wanted to wish you luck with your surgery and to say that you will get a huge amount of support here.

Love Ann x

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Just wanted to say thank you to Judie and Ann for clarification of er+ diagnosis. I really thought it was a worse thing to have, not better. Just feel like I’ve had some good news finally!!!

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Hi again
I had my lymph nodes removed, there was no cancer in any of them other than the one they took out during the SNB…
If the cancer has been cut out and they are going to put me on tamoxifin as they said, what is the chemo for? Is there a chance that there might be some stray cells lurking somewhere?

Hope everyone else is okay? xx

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That’s good news Naz
I’m just back from seeing my surgeon and the cancer is only in the sentinal lymph node and no others.
He said that there is only a very small chance of it coming back as I only had a small tumour. It seem I will be able to get away with radiotherapy and hormone tablets. I am so relieved.

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Hi Naz,I was told to look at chemo as extra insurance.and it would mop up any stray cells that MIGHT have escaped.I had 1.7 cm tumour grade2 with 1 node involved.

best wishes Mel xx

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Hi Mel
Thanks for your reply.
So are you definitely having the chemo now?
Mine was 4cm with one node involved.

Naz x

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NAZ what grade is your tumour?In any case 4cm is quite big and you did have one node involved.I imagine you will be advised to have chemo and I think[though of course it is up to you]you should accept it at your age.