Will I need chemo?

Hi all, I’m new to this whole thing, so need a bit of guidance! I was diagnosed last week with invasive ductal carcinoma (sorry if I’m not using the right abbreviations - I just know what they told me!), and met with the surgeon who said I would have a Wide Local Excision, plus lobular biopsy and reconstruction. Booked in for surgery on 18 June. All this would be followed 6 weeks later by a course of radiotherapy. So far so good, just got my head round that lot, and spent the week organising childcare (I’m a single mum) and cover at work (teacher).
Went for my pre-op yesterday and the nurse said that in her opinion, due to my age (45) and the fact that it’s Grade 3 (which I didn’t know), I am likely also to need chemotherapy. She did say though that because there was no indication at this stage that the cancer had spread to my lymph nodes, it wasn’t a certainty, but that I should be prepared for it.
This has really knocked me for six, and it’s all I’ve been able to think about since yesterday. Why this should be any more worrying, I don’t know, whether it’s because it means the whole process will go on even longer, maybe it’s because it’s all starting to seem very real now, or maybe it’s because there seems that there will be more obvious physical signs (I like my hair…always hated my boobs anyway!!)
Is this really the case? Am I likely to need both? How will I cope through the entire summer and into the Autumn on my own with an 8-year-old?
Thanks all, and best wishes to everyone.

Dear Susanlovelace,

Didn’t just want to read and run, so here’s my little bit to get your query bumped onto the main page. So sorry to hear that you’ve had to join us all here, but you’ll find lots of support, whatever steps you find yourself going through.

Quite a few of us have found that treatment plans can change somewhat since original diagnosis. I too started out believing it was going to be a singe op followed by radiotherapy. I’ve now had two ops, just finished 6 cycles of chemo and have radiotherapy to start later in the summer.

Getting the news that chemo was necessary was the worst part of it all. Still not sure why, but I guess it was a combination of the additional time involved, the potential side-effects and the whole idea of poisoning myself (hence feeling ill) in order to get better. I have got through this on my own with the help of a few friends locally and with the amazing support of other women here.

You also have a young child to consider and will both need some additional support over the coming months. But it can be done. You sound very well-organised and capable and I am sure other single mums who have gone through chemo will be able to give you lots more hints and tips than I can.

Wishing you all the very best,

Dear Susanlovelace
As Gill has said, whatever the doctors say now, could possibly change in the future. As far as having chemotherapy is concerned, some of us who have had it, find it to be not as bad as we expected. But as you have the added worry of a young child, and a demanding job, you will need a network of good friends/relatives to help you in a practical way. chemo courses generally last for 18 weeks, one treatment every three weeks.
If it does turn out that they are right by saying that it is grade 3 then you probably will need chemo. May I suggest that if this is the case, join one of the chemo groups threads on here (Undergoing treatment: chemotherapy). There are currently several groups, for February starters, March, April, May and June. No doubt there will shortly be a new thread for those starting chemo in July. As one of February Valentines, I’ve found being a member of that thread has been invaluable for my peace of mind, friendship with others going through the same thing, advice and frankly a good laugh.
However, if they find after surgery that your grade is lower than 3, especially if no nodes are affected, there might be no need for the chemo at all.

Wishing you good luck for 18th, and sending big hugs.
Poemsgalore xxx

Hi SusanLovelace, I was also told just one op, A WLE, then rads however they found traces in the nodes they took to biopsy at the same time and so i needed another op to take the rest and chemo, I’m having 3rd chemo tomorrow and so far not been as bad as I feared. It is quite common for plans to change after the op as it is only then that the really know what is going on. Having said that try not to worry about what might not happen, take it one step at a time otherwise it can be overwhelming. Good luck with your op xx

Hi Susan,
I am due to start chemo this week. I had a 12mm lump, a lumpectomy and sentinol node biospty (which came back clear thanksully). The consultant mentioned definately having radiotherapy and maybe chemo depending on results from op. When I spoke to the BCN the next day she told me to expect chemo either way, again like you because of my age (33). The results were good from my op but I am still having chemo because of age, grade 3, plus I need herceptin which they administer alongside chemo.
Have they told you if yours was hormone, her2 receptive? As this can sometimes play in the decision making.
I don’t want to scare you but I think there is a good chance they will want you to have chemo - they like to give us the best chance of the cancer not coming back and to catch any stray cells. If you start preparing yourself for the fact that you will probably have it then if it turns out you don’t need it that will be a bonus, rather than getting a shock.
There is lots of support on this site if you do need to have it.
Take care

Hi Susan,
I have to agree with the other posters. Being a grade 3 is one of the criteria for chemo because it is the most agressive grade of the 3 grades, although you may be borderline and be given the choice of chemo or no chemo.

I get the feeling you don’t know a great deal about your diagnosis, and i suggest you ask a few more questions. For example, is your tumour hormone receptive, is it HER2 positive, is there evidence of vascular invasion. Why are they doing a lobular biopsy? Do you mean a sentinal node biopsy? All these may be indicators of whether or not you will need chemo. You will certainly need it if you are HER2 positive because you will be having Herceptin infusions every 3 weeks for 18 sessions (36 weeks) and in primary BC cases this is always given alongside a Taxane chemo drug during the initial 2 or 6 sessions, then on its own.

Flip Flop has good advice when she says prepare yourself for the fact you will need chemo, and if you don’t need it, this will be a huge bonus. Meanwhile, make some plans, put your life on hold for the rest of 2013 (working as a teacher is a big no-no when on chemo because of the risk of infection from the pupils), and remember that fear of the unknown is the pits. Chemo is not as bad as you imagine and there is a wealth of advice and support on these forums, so please continue to join in.

Good luck with your operation and here’s hoping the results are good for you. Please let us know. xxxx

Hi Susan
I was diagnosed January 2012 with a small grade 2 IDC, nodes clear on the scan. My surgeon told me I would have a WLE and SNB followed by radiotherapy, however, my BCN told me from the outset to prepare for chemo due to my age (44). Although my nodes were clear on the scan 1 tiny spec was found so I then went on to have a full clearance, followed by chemo and radiotherapy. I coped well with chemo and continued to work (although being a teacher I appreciate this wont be an option for you) whilst looking after my then 4 year old and running the house, I continued to cook and clean all the way through treatment and take my daughter on days out (my treatment was through the big summer holidays too). I’m not saying I didn’t have bad days, because I did, but on the whole I was relatively well, not everyone has a hard time on chemo, I also have peace of mind knowing that I’ve thrown everything at it.
Take care and let us know how you get on.
Lydia x

Thank you all so much for your help and advice, and I’m sorry it’s taken me so long to reply (you will note I have now changed my user name!) Surgery on 18th went well (as far as I can make out!), and the scars are healing, although the whole breast still aches a lot, with the occasional shooting pain (is this normal?), and I have a rather large lump of seroma under my armpit, which is JUST where my bra sits. I’m back to the consultant on 4 July for results and to find out what happens next so I shall certainly go armed with all your suggested questions, and we’ll see what comes out of it. My main concern is still the effects on my son and how horrible this is all going to be for him, particularly given the fact that I don’t have any other family living nearby. But hey, one step at a time, I guess?!