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Breast Cancer (Expert Forum)
Do I need chemo after a masectomy?
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.
Do I need chemo after a masectomy?
by Tangee, Jan 18, 2009 10:01PM
I had breast cancer surgery in Dec '08. I was diagnosed with invasive ductal carcinoma. I was told that I was type 2.
My actual tumor sizes were less than a cm. They both total 0.9 cm. The masectomy was necessary because of multifocal positive margins and my DCIS size was 3.5. My lymph nodes were negative for carcinoma.
I decided to get reconstructive surgery ( tissue expander along with a saline implant).
My question is why chemo if everything was removed and the lymph nodes were negative? My oncologist said that I'm a high risk but I don't have any history of breast cancer in my family. She suggest that I take 2 mo of chemo (Docetaxel,Carboplatin, Herceptin ) and 7 mo of hormonal **************. Also, what is Her-2 neu status? My estrogen (30%)and progesterone(70%) receptors are positive.
My actual tumor sizes were less than a cm. They both total 0.9 cm. The masectomy was necessary because of multifocal positive margins and my DCIS size was 3.5. My lymph nodes were negative for carcinoma.
I decided to get reconstructive surgery ( tissue expander along with a saline implant).
My question is why chemo if everything was removed and the lymph nodes were negative? My oncologist said that I'm a high risk but I don't have any history of breast cancer in my family. She suggest that I take 2 mo of chemo (Docetaxel,Carboplatin, Herceptin ) and 7 mo of hormonal **************. Also, what is Her-2 neu status? My estrogen (30%)and progesterone(70%) receptors are positive.
Doctor's Answer
by Cleveland Clinic, Jan 19, 2009 12:26PM
, Jan 19, 2009 12:26PM
Dear Tangee, Decisions about adjuvant chemotherapy or hormonal (antiestrogen) treatment are based on several factors including size of tumor, status of lymph nodes under the arm, the appearance of the cancer under the microscope, the presence or absence of hormone receptors for estrogen and/or progesterone, as well as HER2 status, the general health of the patient etc. HER2 neu status refers to whether or not these receptors are found in the tumor specimen.
We can not make specific treatment recommendations for an individual in this forum. We can tell you that antiestrogen treatments are frequently given following surgery for ER-positive breast cancer to reduce the risk of recurrence in the form of metastatic disease. Chemotherapy may add an additional benefit that needs to be weighed against the potential side effects. Her 2 positive tumors generally increase risk to intermediate or high risk which would increase the likelihood of adjuvant chemotherapy being recommended. Your oncologist will be better able to discuss these options with you.
We can not make specific treatment recommendations for an individual in this forum. We can tell you that antiestrogen treatments are frequently given following surgery for ER-positive breast cancer to reduce the risk of recurrence in the form of metastatic disease. Chemotherapy may add an additional benefit that needs to be weighed against the potential side effects. Her 2 positive tumors generally increase risk to intermediate or high risk which would increase the likelihood of adjuvant chemotherapy being recommended. Your oncologist will be better able to discuss these options with you.
Seriously, I sat there getting my poison talking with women who were fighting for their lives again, and again, 2nd and 3rd and yes, 4th time battling cancer. They said to me.. I'm worth it. My kids are worth it. I'll do whatever I have to do. And, so will I, if I have to again. But to ignore cancer cells without frying them to bits with chemo? That's out of the question for me. Best of luck to you and this difficult decision.