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Breast Cancer (Expert Forum)
Chemotherapy Benefit
Answered by
Cleveland Clinic - Breast cancer
Cleveland - OH
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.
Chemotherapy Benefit
by vandi, Jun 17, 2007 12:00AM
I am 61-year old female, (hysterectomy at age 33). Through routine mammography followed by an ultrasound and core-needle biopsy, a non-palpable 2.5 cm, Grade 3 invasive ductal carcinoma was diagnosed in my left breast.
The pathology report from a Lumpectomy performed four weeks later (6/1), indicates a Grade 3, size 3cm tumor, sentinel node positive (9 auxillary nodes removed and negative), Stage 2B, ER positive, PR negative HER2 +1 (negative),
Initial Bone scan ok. Blood test results pending. Recommended course of treatment to begin 6/26 is 3 (21-day) series of FEC followed by 3 (21-day) series of FEC + Taxotere, and then 5 yrs of Tamoxifen. Six to seven weeks of breast radiation are to be given following chemotherapy.
I’m told the aggressive approach is warranted by my age, the high 3 grade and lymph node involvement. While my physicians seem very qualified and I don't challenge the choice of this particular chemotherapy combination itself, I cannot help but wonder why put myself through any systemic treatment with all of its possible short and long term risks if metastasized breast cancer cells can lie dormant and unaffected throughout the chemotherapy then proceed to grow anyway?
Based upon my age and pathology report, is there a significant difference in the percentage of recurrence and aggressiveness if I do the chemo vs. doing only the radiation and Tamoxifen?
The pathology report from a Lumpectomy performed four weeks later (6/1), indicates a Grade 3, size 3cm tumor, sentinel node positive (9 auxillary nodes removed and negative), Stage 2B, ER positive, PR negative HER2 +1 (negative),
Initial Bone scan ok. Blood test results pending. Recommended course of treatment to begin 6/26 is 3 (21-day) series of FEC followed by 3 (21-day) series of FEC + Taxotere, and then 5 yrs of Tamoxifen. Six to seven weeks of breast radiation are to be given following chemotherapy.
I’m told the aggressive approach is warranted by my age, the high 3 grade and lymph node involvement. While my physicians seem very qualified and I don't challenge the choice of this particular chemotherapy combination itself, I cannot help but wonder why put myself through any systemic treatment with all of its possible short and long term risks if metastasized breast cancer cells can lie dormant and unaffected throughout the chemotherapy then proceed to grow anyway?
Based upon my age and pathology report, is there a significant difference in the percentage of recurrence and aggressiveness if I do the chemo vs. doing only the radiation and Tamoxifen?
Doctor's Answer
by Cleveland Clinic, Jun 18, 2007 12:00AM
, Jun 18, 2007 12:00AM
Dear vandi: In general, the recommendation for a node positive breast cancer after lumpectomy in a healthy woman is chemotherapy followed by radiation therapy and hormonal therapy if the tumor is hormone receptor positive . This is based on clinical trials that show survival benefit for those who take chemotherapy compared to those who do not. The amount of benefit (percentage wise) may vary according to a number of other factors including age, hormone status, HER 2 status, etc. Your oncologist may be better able to give you approximate benefit estimations based specifically on your situation. Once you have this information, you can decide if this is “enough” benefit for you to proceed. Specific chemotherapy regimens may also vary according to physician preferences and what country you are from. Hormone therapy would be recommended for any woman whose tumor is estrogen receptor positive.
