would love your opinion

[bones44]

hello all. Newly diagnosed with stage 1 ductal breast cancer, grade 2 (but 1 for mitosis) ER +, PR + both 100% Tumor 1.4mm no vascularity and clear margins after lumpectomy. I am 44. I see my oncologist for the first time next week. Will she be telling me to have chemotherapy? If so why? My daughter is getting married in Feb can chemo be delayed? I am seriously considering bilateral mastecomy & reco because of strong fam history, waiting on results of genetic tests. Found the lump back in Feb but told after mammogram & ultrasound, nothing wrong, 9 months later when lump bigger more tests + biopsy confirmed cancer!!! Now have no faith in imaging!!

[bones44]

thanks so much, I will look at it.

[bluebutterfly2222]

Hi again,

Here is the link to a previous thread where one of our members, SueYoung55,  provided excellent information about most of the different types of reconstructuion available:


http://www.medhelp.org/posts/Breast-Cancer/Trans-flap-vs-implants/show/1308880?personal_page_id=384050

bluebutterfly

[bones44]

Hello girls and thanks for your opinions. I am definitely on your wave length regards the hair thing, in the scheme of things it's not the main issue!! I visited my onc for the 1st time yesterday, she is running one more test on the tumour to determine chemo need. Because the tumour was 100% ER &PR+ she is recommending bil oopherectomy because they feed the tumour and could also become ca with my fam history. Will probs have bil mastectomy and reco at end of all tx and after the wedding in Feb. Cheerpul: What sort of reco are you having & why, if any. ENJOY choosing your MOB dress!!! Dawn: I will pray for you and that your tx goes well.

[Cheerpul]

I am 48, had a mastectomy last year for extensice DCIS, found a .5cm tumor after surgery.  (It was hidden by the ugly DCIS on the imaging.)  ER/PR+ and HER2+.    I had clear, wide margins and no nodes involved.  I had the Oncotype test and scored a 31 because of the Her2 positive.  I took chemo (taxotere, carboplatin and Herceptin) and now just Herceptin and Tamoxifen, along with Zometa, an osteoporosis drug in a study.  I took chemo because of recent studies that have come out about early, small cancers having a higher recurrance rate when Her2 positive and because in my research, I found oncologists recommending chemo for patients with smaller and smaller tumors over time.  (I.e., At first chemo used only for tumors over 2 cm, then 1 cm, then .6cm, and now the latest studies reccommend considering chemo for even smaller tumors.)  

My daughter is getting married in March.  I began chemo Dec. 29, 2009.  Last taxotere and carboplatin were taken March 2, 2010.  I went without a wig or head covering at the end of August with my hair covering my head adequately.  Remember, it is not whether you attend your daughter's wedding with your own hair, a wig (which often look great) or a creative scarf, but that you attend your daughter's wedding, and her many other significant moments in life.

I am meeting with my surgeon tomorrow morning to schedule a prophylactic mastectomy and in the afternoon will take my second-to-last Herceptin treatment.  I will look for a mother of the bride dress after I have my surgery (shooting for mid-December after I sing solos for Messiah so I can sing on Christmas Eve.)

We are here to help you through whatever treatment you take and I am thinking of you.

[Dawn48]

I recently am going threw the same left breast .09cm tumor found stage 1, b type .but tomorrow i start chemo i just wonder if it necessary ,Not in lump-nodes.But they feel because i;m young that i risk it coming back in  10  years so it would be good if i do this aggressive treatment 4 chemo every 3 weeks then start radiation and then take tamoxifen.jUST SCARED OF THE SIDE EFFECTS

[bones44]

Thanks for your input, yes this girl also had Her+ and a grade 3. Wish for her she had had chemotherapy at the start. 2 of my best friends have died of bc in the last 7 years and because I am newly diagnosed I think some news still freaks me out.  I will try and keep my mind open and free from negativity until seeing my oncologist Monday.
Thanx

[bluebutterfly2222]

We never know the course BC may take, but some cases, such as yours, have a better initial prognosis.

Less favorable prognosis is associated with lymph node involvement (and of course advanced stage/distant mets at time of dx), Her2+ status, Triple Negative Status, and highly aggressive tumor grade.  (The person's case your friend told you about may have had some of these elements.) However, new treatments for BC have offered improved outlook today over that of previous years, and we all hope and pray for contined progress against this disease.

I'm sure  the onco will help you choose the best tx for your case, and you are wise to keep an open mind as to what is best for your entire future, not just the wedding date.

bb

[bones44]

So sorry about the maths, yes I do mean 14mm or 1.4cm. Will be looking up this oncotype Dx test for sure. Had started to think that my prognosis was excellent post surgery findings but got a bit freaked yesterday after talking to my close friend about someone dear to her who is having 2nd chemo course in 7 yrs after presenting lately with bone mets. When I asked if she had originally had lymph node involvement the answer was NO. She also did not have chemo at the start. In the last 7 years she has also had chemo for liver mets which was resolved. I do not want to take any risks and regret it. I would love my own hair at my daughters wedding though. I will keep you posted.

Thanx

[bluebutterfly2222]

1.4 mm is not larger than 1 cm. Perhaps you mean 14 mm, which would equal 1.4 cm?  

Since you now   state your tumor  apparently  larger than 1 cm, chemo may be a consideration, but for many  oncos this would not at all be a definite indication, esp. with no pos. lymph nodes,  Her2- status, and the alternative of hormonal therapy available d/t your ER+/PR+  hormone receptor status.  

Your case sounds like an ideal candidate for the Oncotype Dx test, if your doctor suggests that you consider chemo.

Please keep us posted regarding what you find out.

bluebutterfly

[bones44]

Thanks for responding. The tumor I had was 1.4mm ie bigger than 1cm, does this generally automatically put me into 'chemo' territory? The tumor I had was HER2 neg. I will ask the oncologist about the Oncotype Diag test, I wonder if that is the one my surgeon mentioned, which here in Australia costs about $2-3000.

Thankyou also for your best wishes!

[bluebutterfly2222]

First a caveat: What follows is just  an educated  guess from a non-professional. Your oncologist may have a completely different take on your situation.

If you had no lymph node involvement, since your tumor was under 1 cm and not highly aggressive, you probably won't need chemo.  (For people that do need it, no, it could not be delayed that long, as that would allow time for any microinvasions to spread.)Radiation therapy may be recommended, or just hormonal therapy. You did not indicate your HER2 status; if it is positive, Herceptin may be recommended.

An Oncotype Dx test may be useful if there is indecision doubt about whether or not someone should have chemo. The  Oncotype DX test is recommended for breast cancer patients who are newly diagnosed, lymph node-negative, estrogen receptor-positive, stage I or II, and who will be treated with chemotherapy or hormone therapy. Early findings from prospective trials indicate that a low Recurrence Score may determine which patients with ER+, node-negative breast cancer can be treated with hormone therapy and thus do not need chemotherapy.

.Best wishes...