Breast Cancer Expert Forum
Chemotherapy and/or Hormonal Therapy
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Questions posted in the Breast Cancer Forum are answered by medical professionals and experts. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

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Chemotherapy and/or Hormonal Therapy

I am 59 and diagnosed with Infiltrating ductal carcinoma.  My family has no history of cancer.

On February 5, 2005, I had a Lumpectomy :  size:  1.8 x 1.2 x 1.0 cm;  Modified Bloom-Richardson's grade 2 (tubular 3, nuclear 2, mitotic 1).  Intermediate grade cribriform DCIS was present.  Margins narrowly negative (< 1mm from margin).

On February 28, 2005, I had a Partial mastectomy and SNB.  Three of 6 specimen showed residual ductal carcinoma in situ, cribriform and micropapillary patterns with margins narrowly negative within 0.1 cm of newly inked surgical margin.  The Sentinal lymph nodes No. 1 and 2 were negative for tumor.

On March 8, 2005, I had a Simple mastectomy done on my right breast.  Right breast was positive for infiltrating ductal carcinoma.  Size:  0.3 cm.  Extensive intraductal componant:  present and separate from the invasive carcinoma.  Margins were widely negative.  Ductal carcinoma in situ was found, cribriform pattern, multifocal approximate size 1.9cm.   Necrosis and fibroadenoma both identified.  Breast Panel:   Estrogen receptors: positive at 3+; Progesterone receptors: positive at 1+;   HER2/neu:  negative for overespression (1+);  Ki-67:  Low, less than 10%.  Modified Bloom-Richardson's grade = 1 (tubular1, nuclear 1, mitotic 1).

What should be my next course of treatment...chemotherapy, and/or hormone therapy?  When can it begin?
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Dear maggie524, The decision to give adjuvant treatment (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) is made based on several factors including; tumor size, stage of disease, tumor features, hormone receptor status, menopausal status, the patient's overall health, any other health concerns.  A discussion of options and the risks and benefits of specific treatments as they apply to the person's individual situation would best be discussed with a medical oncologist.  
In regards to beginning adjuvant treatment, this starts when a person has recovered from surgery - usually after about 4-6 weeks.  If both hormone therapy and chemotherapy are recommended, hormone therapy would usually commence after the chemotherapy is completed.

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