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Breast Cancer (Expert Forum)
Chemo or no chemo?
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Chemo or no chemo?
by mun, Sep 14, 2001 12:00AM
I was diagnosed w/ invasive breast cancer on 7/6/01. My pathology report showed: .8cm w/ positive margins, high grade, extensive perineural invasion & extensive high grade comedo DCIS. Tumor markers: ER/PR+, Her-2 negative, S-Phase 8.5%.
On 8-17-01 I had a lumpectomy because of the postive margins plus sentinel node biopsy. 3 nodes were removed; they were all negative. There was no residual tumor, so the docs are saying my tumor was still .8cm. I know I will need radiation therapy because I had a lumpectomy. My question is this: I've gotten 2 opinions regarding further treatment. I have one dr telling me that I don't need chemo, Tamoxifen will be enough. And I have another dr recommending chemo. The 2nd doc says chemo will improve my 10 year survival by 6%. The first says that chemo will improve my 10 year survival only by 1%. What do you think?
On 8-17-01 I had a lumpectomy because of the postive margins plus sentinel node biopsy. 3 nodes were removed; they were all negative. There was no residual tumor, so the docs are saying my tumor was still .8cm. I know I will need radiation therapy because I had a lumpectomy. My question is this: I've gotten 2 opinions regarding further treatment. I have one dr telling me that I don't need chemo, Tamoxifen will be enough. And I have another dr recommending chemo. The 2nd doc says chemo will improve my 10 year survival by 6%. The first says that chemo will improve my 10 year survival only by 1%. What do you think?
Doctor's Answer
by CCF-RN,MSN-JS, Sep 18, 2001 12:00AM
Dear Mun, Recommendations for adjuvant chemotherapy are based on various factors, tumor size, lymph node status, as well as whether there is evidence of metastasis. This gives information to “stage” the cancer. Your cancer, based on the information you provided, would be stage I. For many years it was not customary to treat Stage I breast cancer with chemotherapy or hormone therapy. However, recent trials suggest that Stage I patients will benefit from adjuvant therapy. (Adjuvant treatment is treatment given after surgery to try to prevent or minimize the growth of microscopic deposits of tumor cells that might grow into a recurrent tumor). Adjuvant therapy usually begins within four to six weeks of surgery or radiation.
Two large trials by the National Surgical Adjuvant Breast Project (NSABP) showed significant reduction in recurrences in the opposite breast at four-year follow-up for estrogen-receptor-negative patients given chemotherapy and for estrogen-receptor-positive patients treated with tamoxifen.
According to the 2000 National Institute of Health Consensus Conference on Adjuvant Therapy for Breast Cancer. Adjuvant chemotherapy is recommended for the majority of women with primary breast cancers that are greater than 1 cm in diameter. This is independent of nodal, menopausal or hormone receptor status.
Yours is a good question, but the decision whether or not to go ahead with chemotherapy is going to be up to you, considering the risks (side effects of the chemotherapy) and benefits (possibility of decreasing the risk of cancer recurrence). Tamoxifen will probably be recommended either way to decrease chances of cancer in the opposite breast.
Two large trials by the National Surgical Adjuvant Breast Project (NSABP) showed significant reduction in recurrences in the opposite breast at four-year follow-up for estrogen-receptor-negative patients given chemotherapy and for estrogen-receptor-positive patients treated with tamoxifen.
According to the 2000 National Institute of Health Consensus Conference on Adjuvant Therapy for Breast Cancer. Adjuvant chemotherapy is recommended for the majority of women with primary breast cancers that are greater than 1 cm in diameter. This is independent of nodal, menopausal or hormone receptor status.
Yours is a good question, but the decision whether or not to go ahead with chemotherapy is going to be up to you, considering the risks (side effects of the chemotherapy) and benefits (possibility of decreasing the risk of cancer recurrence). Tamoxifen will probably be recommended either way to decrease chances of cancer in the opposite breast.
Member Comments (4)
by mun, Sep 16, 2001 12:00AM
Oh, I forgot to tell you I'm 47 years old & 2 years post menopausal. Thanks
by Colonel, Feb 18, 2002 12:00AM
I am a male with breast cancer and also a liver transplant recipient. Have had a masectomy and 11 positive nodes out of 18. Chemo will be very risky because of my liver. What if I only took tamoxifen? Also considering a test called PET which shows whether the cancer has metasitized. Any info would be appreciated. Thank you.
by Colonel, Feb 18, 2002 12:00AM
I am a male with breast cancer and also a liver transplant recipient. Have had a masectomy and 11 positive nodes out of 18. Chemo will be very risky because of my liver. What if I only took tamoxifen? Also considering a test called PET which shows whether the cancer has metasitized. Any info would be appreciated. Thank you.
