You are now entitled to have an Oncotype DX test on the NHS, which is the test that some of the earlier posters on this thread mentioned. NICE have been reviewing this test for some time, and have recently (September 2013) announced that they have approved it. This test indicates whether you will benefit from chemo or not, so I suggest that you ask your oncologist for this test. Here is the link to the NICE announcement on the subject: http://www.nice.org.uk/newsroom/pressreleases/NICERecommendsTestBreastCancerTreatmentDecisions.jsp
Another point worth knowing is that the NICE guidelines do not allow your oncologist to offer you the option of Tamoxifen + Zoladex up front, so you don't get to hear about it until you have been offered and turned down chemo. In my opinion this stinks, since you are being asked to decide without being given full information. My oncologist told me (after I had said no to chemo) that Tam + Zol gives similar protection to some of the more old-fashioned chemo types, not quite as high as the latest ones.
After reading your posts I'd like to share my treatment experience at Marsden.
DX Nov. 2012 ILC Grade2, 7cm ER+, HER-
Been on Zoladex+Tamoxifen for many months, now the tumor size shrunk to - multyfocal fragmented 5cm.
Ki67 initially 11% now gone down to 3%. Despite this my oncologist at Chelsea site suggested to go ahead with neoadjuvant 4EC + 4Taxol chemo which should start later this week.
I thought that i like you would not benefit from chemo however they want me to try it before my surgery.
Where at Marsden did you have your treatment, what team?
Now I have to decide for or against chemo.
Please write your thoughts if you can before I start chemo.
I asked if they could test the tumour for Ki-67 which tests the proliferation rate of the cancer cells. I first heard about it on this site. Over 20% and the advice would be to use chemo. Mine came out at 8%, so the oncologist then offered me monthly zolodex injections for 2 years. It would seem that zolodex isn't offered as an alternative treatment plan unless the woman turns down chemo. So the treatment for me is radiotherapy, zolodex, tamoxifen for five years, with Letrozole for a further 2 years.
The Marsden recently told me that the treatment plan was the most appropriate for me and it would be very unlikely that I would be back there with secondaries in the years to come. Obviously, there are no guarantees, but there isn't with chemo either. I think the choice would be to weigh up the benefits of chemo against the long-term side effects.
I am comfortable with my treatment decision, and should it ever come back, I won't regret not having chemo.
Incidently, the breast cancer PREDICT tool on the NHS website now includes the Ki-67 test, so it would seem it is becoming more widely used.
Good luck in your choice of treatment, and I wish you all the very best. xx