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?

[CCF-RN,MSN-JS]

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.