Hi, I have just had a wide local excision for breast cancer. Fortunately there is no cancer in my nodes but the tumour was a grade 3 and I have been told that chemo as well as radiation could be recommended. Has anyone else been in this position and if so will chemo greatly reduce the risk of cancer returning than if I just have radiotherapy.
Hi Bettie
Your recurrance/survival stats will be particular to you - they take into account the type of cancer, size, your age etc. Your oncologist is the person to ask to get accurate info for you.
It was worth it for me - I had a Grade 3 lobular tumour, it was big and multi-focal so I had to have an mx, but my nodes were clear. According to my onc, having chemo and tamoxifen increased my chances of being here in 10 years by 13% and cut my risk of recurrance from 50% to under 25%.
Good luck with your decision.
Dx
Bertie it is horrible to have to make this kind of decision . If your oncologist thinks it will improve your chances by even 3% it would be considered Gold Standard practice to offer you chemo. It is an all over treatment administered into the bloodstream . A bit like a weed killer on soil - it will kill off stray Cells that might be present elsewhere because they have escaped without leaving a trace in the lymph nodes. Grade three tumours are the most unlike normal cells and divide faster. This makes them sometimes very sensitive to chemotherapy . They can be affected by chemotherapy better than slower growing cells like a grade one or two. . The body’s natural defences can kill cancer cells but chemotherspy attacks and kills them at different stages in their growth.
Chemo is no picnic but it is doable. It is a bit like childbirth you forget it quickly. I finished FEC-D just before Christmas and it is only a dim memory now. Your grade , the size of the tumour, lymph and vascular invasion and the Er PR + Her2 status will all be used to give you the statistics.
You might like to call your BCN and ask what the recommendation of the Multidisciplinary team meeting was.
You might want to call the Helpline and go through it with them. they are so knowledgable and understanding. I have often called them during a blip.
The other thing is if you find you really can’t take anymore you could discuss stopping it with your team.
If you don’t have it and you had a problem at a later date, would you blame yourself or feel you did not take everything that could have helped you.
I so hope all will be well for you and you can make a " informed decision"
Big Hug because you deserve it
Cackles
Hi
Just want to empathise. Today I got my path results. Stage 1, Grade 2, Er+ and also Her2+. Like you have been offered chemo and Herceptin and have a week to make my decision.
So no answers for you but just wanted to know that you are not alone with this dilemma.
Smiles
Pesteringpixie
Yes Bettie,
In Nov diagnosed with Stage 2, Grade 2 invasive lobular BC, no LN either, but was still told high chance blood spread. My Onc used online Adjuvant to tell me my 10yr chance of recurrence. My chances were 37% chance recurrence with just surgery, I had WLE then MTX, but vwith chemo and tamoxifen my chances reduce to 11%. For me this made it an easy decision,tou could ask your onc for similar figures if you wish, or BC nurse.
Fiona
I was same as you - stage 1 but grade 3 - cause of age never really mentionned as an option - onc just said it was best to have it as improved chances of no recurrence - mine is triple neg so none of the other ongoing meds would help. I am nearly 4 of six done (no 4 on Friday) - really hasn’t been bad - well worth any improved chance of long term survival!!
Hi
I found my lump a year ago and had mx with reconstruction on 18th April. My lymph nodes were clear and my 3.8mm tumour was HER2+. I followed with 3 FEC and 3 docetaxel chemo and 15 radiotherapy sessions. I have now had 8 out of my 18 herceptin treatments and was told that all my chemo, rads and herceptin were my insurance policy against a recurrence. I wasn’t told any % chances and quite frankly they are only based on statistics - nobody can give you any accurate figures - let’s face it everyday life is a game of chance. If you looked at road accident statistics you wouldn’t even think about getting in a car.
As far as I was concerned the more treatments to guard against a recurrence the better so I opted for the ‘Full Monty’. Breast cancer treatment is a costly business - my herceptin treatment alone costs more than £30K and I am sure the NHS wouldn’t spend it if it didn’t work.
As has been mentioned, chemo is doable so don’t be afraid of it. I can’t say that I was looking forward to it, but it was nowhere as bad as I imagined it to be. OK losing your hair, and then your eyelashes and eyebrows is not a prospect I was looking forward to, but it is a darn sight more preferable to losing my life. 6 months after my last chemo my hair is now growing back as are my eyelashes and eyebrows.
Why do you not want chemo? If it is fear of the unknown then listen to all of us ladies here who have been there, done it and have come out the other side. Discuss it with your oncologist and remember that you MAY experience the side effects, but then again, you MAY NOT. And if you find that you really can’t cope with any side effect then tell your oncologist as they can always find a solution.
Good luck with what ever it is you decide, but remember that you are being offered the best possible treatment for YOU as an individual, but, ultimately, only you can make that decision.
mazzalou, just wondered what grade was your lump?
TTM xxx
Bettie, I’m going to say have the chemo, because even though you don’t have node involvement, there is still a slight chance that you have cancer cells circulating in your bloodstream. While it’s probably not the case, I would hate you to play the statistics game, and lose. Grade 3 is a fairly aggressive tumour, and you really don’t want to be stage 4, with a grade 3 tumour do you?
Grade 3 - I think most HER2+ are grade 3 because they are fast growing due to their over-expression of growth hormone but please somebody correct me if I am wrong
I am HER2+ with a grade 2.
Am all over the place trying to make my decision about chemo - and find the support here of real value, Bettie.
Broadly speaking 30% of node negative breast cancers recurr theoncologist.alphamedpress.org/content/16/suppl_1/51/F5.large.jpg in the US they use the Oncotype DX to work out your recurrence score if you are node negative, unfortunately this test is not available on the NHS yet but can be done privately. Many other factors are considered to estimate your recurrence risk, this may be helpful : lifeabc.org/risk_recurrence_more.html
Also, a lot of oncs use adjuvant online to show their patients what benefits treatments have.
The annual St Gallen Oncologist Conference has further information relating to risk of recurrence.
gaeainitiative.eu/word_page/BC_Recurrence.htm
Of course, only look if you want to see details of recurrence statistics, no one can give you a personal guarantee but the initial primary treatment is considered given with curative intent and your medical team will offer the treatment which gives you the best possible chance to remain disease free in the future.
I have been on these forums for a couple of years now and have seen ladies with no node involvement be diagnosed with secondary cancer more times than I would like (especially as I am a grade 3,stage 1,no nodes lady too). I would agree with Tina that the oncotype test may be very useful for you. There are many different parts of a tumour cell that suggest whether this cancer is more likely to have spread, and this test measures these various bits. If you are in two minds I would go for it. Personally, I had chemo and radiotherapy (not perception as not her+ve) and would have grabbed anything that gave me the vaguest extra chance at survival. Each to their own, but if my good diet and healthy regime didn’t stop me getting cancer in the first place I’d be worried about the wisdom of then depending on it to stop me getting secondary cancer. Good luck with your decision, they are not easy ones to make.
Hi there
Like a recent posting I was advised that regardless of tumour size and node involvement I was grade 3 due to the aggressivenss of being HER2 positive. Like another poster I too felt that ‘throwing everything at it’ was worth it. Anything to give me a better chance in the long run was right for me. Best wishes all. J.
Please do take the advice of your onc and have chemo.
I know everyone’s path report is different and that everyone responds to chemo differently but I can only go off my experience.
I was dx nearly 4 years ago with grade 3 and 3 nodes affected. 3 years after chemo I’m here enjoying life (and rarely visiting these boards). My friend was dx 2 years ago, grade 3 with no nodes affected, refused chemo and died last summer.
Chemo would not be at the top of my ‘fun things to do’, but if the onc recommends it then he must feel that it is in your best interests and it will give you the best prognosis.
My friend refused because she was scared. Who isn’t? But it really isn’t as bad as you think and if it gives you the chance of becoming an old lady, watching your kids and grandkids grow up, then the few months of treatment is worth it.
Of course there’s no guarantees and you could still live to a ripe old age without chemo, but maybe not. Personally as others have said, I wanted to throw everything at the damned BC in the hope that it wouldn’t come back. So far, so good.
Hello
Just want to put my recent experience into the mix. I was diagnosed after routine mam last Nov and had surgery WLE in early January. My tumour was 21mm (mix of two 1@18mm 1@2mm)located in the same area. No lymph involvement. Cancer was ductal type 3 agressive HR+. The size of tumour/s just took me into chemo bracket and I was so disappointed when surgeon told me. Onchologist said that we could talk percentages but he’d rather not because that is all patients think about when they leave his office. He said having chemo gave me moderate improvement over not having it and every chance etc. I didn’t go into appointment thinking I wasn’t going to have it but hoped he would turn around and say I didn’t need it. That wasn’t the case and I have now had my first session of chemo and on day 11 post treatment. They gave me so much medication to take home with me to support any poss s/e’s. I’ve had no nausea but like everyone you do get tired. So you rest and take care of yourself. The Chemo Helpline at the hospital is always there to talk to you no matter what. Nothing is too much trouble. Chemo Unit staff are wonderful along with everyone else.
My identical twin was first diagnosed with BC 20 years ago and if she had said no to chemo I don’t think she would be here now. She said to me “You can’t get the time back if you make the wrong decision. Take everything they want to throw at you”. We were diagnosed with the same size and type cancer, but in opposite breasts. I hadn’t thought about it until a nursing friend of mine said that as we are identical (two from one egg)she was the right side of egg and I was left. Looking at it that way is makes sence, I suppose. I have been regularly checked over the years until I got into my 50’s then they put me on 3 year check - mistake but nothing I can do about it now.
Getting back to you and your decision. If I had walked out of the Onchologist without agreeing to have chemo then I would be worried. If my tumour had been 18/19mm the surgeon was going to just send me for radiation. That’s too close for comfort as far as I’m concerned. In fact it’s quite scary. There’s lots of chemo treatments and they effect people in different ways. They don’t want you to feel awful whilst going through treament and give you everything you need. One lady on our March Chemo thread said “Ask for what you kneed”. That’s firmly in my mind and it works. I’m not fearful of my next session - it will be one more closer to the end. I need to have four sessions and then rads and tabs for 5 years.
Give it a shot if you can. That way you will know that you couldn’t have done anymore. There’s no certainty in life no matter what we choose. At the end of the day you will make the right decision for you when the time comes.
Sending you my best wishes
Beryl XX
Hi Beryl. do you know where everyone is. I’ve just posted on March’s chemo but there is about a month missing and I can’t find anyone!!
Hope you’re ok and we can all catch up again with each other
Bettie