Breast Cancer treatment with LIV and ER, PR positive Her2 Neg Grade I tumor and Mib1: Low

[lakehouse1]

I recently had a bilateral mastectomy after having a biopsy of the right breast which came back positive with invasion duct carcinoma.  First core biopsy should no lymphovascular invastion, however the biopsy of the mastectomy tissue should LIV.  My tumor was a grade 1( tumor size .9cm) and I had 1 positive node for metastatic carcinoma  5mm with no extranodal extensions. I had implants which were 20 years old and the right breast with the cancer the implant had erupted.  Left breast had no cancer.  I am ER, PR positive and Her2 negative. My Mib1 is low.  I understand the advantages to hormone therapy but what about chemo with hormone therapy. If there is only a 4% increase of benefit why do the chemo.  Not very clear on my choices for treatment

[Cheerpul]

I have to agree with japdip and SueYoung55.  You know that cancer cells have moved from the original site because of the lymph node , so chemo is indicated.  The goal is to make this a once-in-a-lifetime experience.  Your bilateral mastecomy was a great start.  Now you and your doctors need to plan the adjuvant treatment that kills any cells that spread into the lymph system and/or bloodstream and blocks the hormone receptors that feed cancer cells.  That would be chemo and either tamoxifen or aromatase inhibitors.

The thought of chemo is daunting.  It is a tough experience.  Last year, I had chemo from December 2009 through March 2010 of chemo (taxotere, carboplatin and herceptin) and it was about th end of April before I started to really feel better.  However, I worked fulltime and then some throughout and am doing great now.  I had no nodes involved and a .5cm tumor that was ER/PR + and Her2 positive.  It was a hard decision to make to take chemo, but my Oncotype score clinched it.  (A 31 indicated a recurrance rate of 30 -40 percent with just hormonal therapy and no chemo and a less than 10% rate of recurrance with chemo and hormonal therapy.)  Moreso, I have gained valuable peace of mind that I did all that I could through treatments and 2 mastectomies and now I am concentrating on living life to the fullest every day and looking ahead.

Work on your relationship with your doctors and nurses so that you feel  comfortable talking with them and voicing your concerns and fears.  They can help you with thorough explanations and discussions.  Many medical centers also offer educational, and other support programs.  You are not alone with this decision and you will not be alone as you continue your treatment.  We in this community will also support you however we can.  Please reply back on this thread with any concerns you have.  I am thinking of you.

[SueYoung55]

Absolutely I'd have chemo with that diagnosis. I had two nodes involved and had chemo & radiation. Everyone is talking percentages anymore but the fact is it's already spread as evidenced by your pathology report.

Chemo destroys the microscopic cancer cells floating through your blood stream and lymphatic system.... it goes after what surgery can't get to... the lil suckers that slipped past already. Did you know it takes 3 million cancer cells clustered together to show up as a small spot on a PET scan? Chemo is like PAC MAN... it eats up cancer cells and spits them out!

Best wishes and sorry if I'm a little overly enthusiastic this evening.. I've made and eaten some of the best donuts I've ever had with homemade chocolate icing and I think I'm in a sugar high LOL

[japdip]

Chemo would be standard if there was lymphnode involvement. Anytime the lymphatic system is positive for cancer Chemo is the first line treatment. I think you should have a serious and detailed discussion with your Oncologist regarding the recommended treatment and the reasons for it. He/She has all your detailed medical information on which treatment is based; I really don't see much of a choice here considering the information you have supplied.   Regards ....