I need to decide about CMF chemo. I had a double mastectomy for extensive DCIS in one breast. Other was prophylactic. Final pathology showed one 3mm invasion plus at least 10 foci of microinvasion. Oncologist said since the diameter of each invasion is not counted (only largest tumor), no chemo. Then he checked with other oncologists on staff and some think chemo might be warranted given the number of microinvasions. I'm told oncologists on staff are split 50/50. One said chemo would be treating my mind rather than my body. I am 53 years old and triple negative. No node involvement based on removal of two sentinel nodes on cancerous side. Oncologist now says he will give me chemo if I want it although he still seems against it. I'm told risk of recurrence is three percent and chemo will lower that to two percent. But there seems to be no real consensus on how to count the microinvasions. Doesn't that affect the risk calculation? I don't know what to do.
If the "oncologists on staff" are that evenly split in regard to their recommendations, I think that leaves it up to you to decide which approach YOU feel more comfortable with. (Some patients want to leave no stone unturned in protecting themselves against possible recurrence, while others wouldn't consider chemo unless they were told it was essential in their particular cases.)
If you are still confused and unable to decide the best course for you, another idea might to get a consultation for another opinion from an oncologist outside of the group you are dealing with, preferably one at a major cancer tx center or a medical school (if that's not the type of oncologist you currently have). A medical school professor who supervises residents in oncology would be likely to have reviewed all the relevant research and have definite ideas about the issue of how much weight should be given to the microinvasions in making recommendations about chemo.
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