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.