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Chemotherapy or no chemotherapy in DCIS
Hello,
I'm writing on behalf of my wife, she is 42 years old, premenopausal, and being treated (radiation therapy to come) for invasive ductal carcinoma, without any evidence of spread to nearby lymph nodes or distant sites, 1/0,8 mm tumor, low/moderate grade tumor, er+, pgr+, no family history of breast/ovarian cancer.
Although our oncologist generally treats young women more aggressively, my wife's tumor is so small he has recommended just radiotherapy. He has recommended tamoxifen for 5 years after radiotherapy. We understand that in the context of risk vs benefit chemotherapy in my wife's case doesn't make sense.
Most of the benefit she would derive would be from a reduction of risk of contralateral disease, and tamoxifen as prevention seems a little more complicated. How long does she takes it, more than 5 years? When does she stops receiving a benefit? If she only takes it for 5 years, which 5 years does she chooses, the riskiest ones (later on in life)? Does she add medication to suppress ovarian function? She needs an ovarian ablation or suppression? Is it possible to spawn a tamoxifen "resistance", so that if a recurrence or new primary came up it would be er-? If chemotherapy is not recommended for my wife, and she is at a high risk for contralateral disease, whom would it be recommended for? What are your thoughts on tamoxifen for reducing risk in someone like my wife?
Another question is this: she has gotten 2 opinions regarding further treatment. One doctor telling her that she don't needs chemotherapy, Tamoxifen will be enough. And she has another doctor recommending chemotherapy. The 2nd doctor says chemotherapy will improve her 10 year survival by 6%. The first says that chemotherapy will improve her 10 year survival only by 1%. What do you think?
Please tell me if tamoxifen is really necessary in my wife’s case. She has ER positive 30%, PGR positive 50%; CerbB2 negative; Ki67 positive <5%; EGFR positive in vessels (microangiogenesis +++)
Any insight would be of great help to us at this anxious time.
Thank you so much.
I'm writing on behalf of my wife, she is 42 years old, premenopausal, and being treated (radiation therapy to come) for invasive ductal carcinoma, without any evidence of spread to nearby lymph nodes or distant sites, 1/0,8 mm tumor, low/moderate grade tumor, er+, pgr+, no family history of breast/ovarian cancer.
Although our oncologist generally treats young women more aggressively, my wife's tumor is so small he has recommended just radiotherapy. He has recommended tamoxifen for 5 years after radiotherapy. We understand that in the context of risk vs benefit chemotherapy in my wife's case doesn't make sense.
Most of the benefit she would derive would be from a reduction of risk of contralateral disease, and tamoxifen as prevention seems a little more complicated. How long does she takes it, more than 5 years? When does she stops receiving a benefit? If she only takes it for 5 years, which 5 years does she chooses, the riskiest ones (later on in life)? Does she add medication to suppress ovarian function? She needs an ovarian ablation or suppression? Is it possible to spawn a tamoxifen "resistance", so that if a recurrence or new primary came up it would be er-? If chemotherapy is not recommended for my wife, and she is at a high risk for contralateral disease, whom would it be recommended for? What are your thoughts on tamoxifen for reducing risk in someone like my wife?
Another question is this: she has gotten 2 opinions regarding further treatment. One doctor telling her that she don't needs chemotherapy, Tamoxifen will be enough. And she has another doctor recommending chemotherapy. The 2nd doctor says chemotherapy will improve her 10 year survival by 6%. The first says that chemotherapy will improve her 10 year survival only by 1%. What do you think?
Please tell me if tamoxifen is really necessary in my wife’s case. She has ER positive 30%, PGR positive 50%; CerbB2 negative; Ki67 positive <5%; EGFR positive in vessels (microangiogenesis +++)
Any insight would be of great help to us at this anxious time.
Thank you so much.
I think you just need to gather information and your wife needs to decide what is right for her. I was 50 when diagnosed, pre-meno, not in my nodes, had similar tumor size to your wife, only I was triple negative, so couldn't be on the five year medication. I opted for chemo and radiation. Although my oncologist said I could chose not to do chemo, the reason she gave me for doing chemo was that MY type (not necessarily your wife's type) of cancer, IF it returned, would probably come back as bone cancer or liver cancer. In that case the cancer is usually bad before it is detected and the prognosis not as good. On the contrary, my mom had breast cancer, small tumor, meds for 5 years, and ONLY radiation, and she has been cancer free for over 7 yrs. I feel for you & your wife, as there are no clear cut answers. Just gather all the info you can and make decisions that you can live with. I wish you well.
Your question was answered previously; I believe it was on Feb. 27th. Thank you .....
Does she have DCIS or invsive ductal carcinoma? I am not an expert by any means, but I have done some reading, and from what I have seen, they usually recommend radiation and lumpectomy or mastectomy for DCIS, but the treatment for ductal carcinoma might include chemotherapy also.
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