Dear jema: In either case, tamoxifen would be advised. In trying to evaluate benefit, it is not entirely clear. The benefit for you might range from 2%-5% over a 10 year period. There is a very good write up in Dr. Susan Love's Breast Book c2000 pp. 386-388. It is too long to include but may help to clarify the difficulty in advising on this. You can probably get a copy of this book at your local library and copy these pages or pick it up at the bookstore. It usually runs about $20 dollars.
I'll throw in my 2cents as I had a somewhat similar story. My tumor was 1.6cm, nodes clean, good margins, and both 98% Er+/Pr+. My S-factor was a low 1.8%, so slow growing. The first oncologist recommended chemo based on the size... usually it is recommended for tumors greater than 1cm. I got a second opinion and the second doctor said he felt I'd only get 1-2% gain from it. Usually the gain is more, but since my cells were dividing so slow, he didn't think it was worth the risks of chemo. However, he said 80% of oncologist would recommend chemo and if I wanted to go for the 1-2% I could. Well, after much soul searching, I opted not to. I worried about it a lot at first. However, since then (I'm coming up on my 2 year anniversary) I've read studies that have found hormonal therapy as effective as chemo and hormonal therapy in post-menopausal women with early stage node negative cancer. So it all comes down to: can you live with a decision not to go for the extra 1-2%. If you're going to worry about it forever, then go for the chemo. Otherwise, I would definitely consider not doing it.
Hi - We have two ladies in our support group, one had 3 positive nodes, no chemo, tamoxifen only, it's been 13 years. One had 1 node, no chemo, tamoxifen only, 8 years. I think chemo is very hard on your body and that 1-2% just doesn't sound worth it. But you have to make your own decision. Just a thought.
Hi,
I am now going through the same decision process. My nodes were negative and my receptors are positive 80 ER and 90 PR. I too have heard the 1-2% as well as 2-3%. It does scare me when my doctor talks about a cell slipping through the nodes. Right now they say that with just radiation and tamoxifen there is a 89-90% chance of non recurrence. My s-phase is very low .7%, but no one has talked about that. To me that sounds as if the tumor was all but dormant. Should I ask about the s-phase when making this decision?
Thanks....Katharine