IDC Treatment

I had a lumpectomy 3 weeks ago for 1.5cm stage 1 grade 1 prer+ her- tumor. The local oncologist I saw Friday recommends radiation, followed by hormone therapy. I was also offered radiation since I am 46, but it not a must. I have no idea what that means, not a must. My margins were clear and no node involvement. Could you Please explain to me what this means? Do I still have cancer or is it gone with the surgery, I am very confused.  Thank you so much.

[Cleveland Clinic]

Dear Madi1,  After surgery for breast cancer there are recommendations for what is called adjuvant treatment.  Adjuvant treatment is treatment given to try to prevent or minimize the growth of microscopic deposits of tumor cells that might grow into a recurrent tumor.      

When making recommendations for adjuvant treatment of breast cancer many factors are taken into consideration such as size of tumor, ER/PR status, Her2 status, overall health of the patient etc.  After lumpectomy, radiation treatment to treat the rest of the breast is the usual treatment, but this just treats microscopic deposits of tumor cells that may be in the remaining breast tissue.  In ER/PR positive breast cancers hormone therapy to suppress estrogen is common.  

It could be that it was chemotherapy not radiation that was offered but is “not a must”.  The decision regarding adjuvant chemotherapy would take into consideration risks and benefits to the individual patient.  This is a discussion to have with the oncologist who could clarify this and discuss the risks and benefits of adjuvant chemotherapy in your specific situation. You may want to discuss with your oncologist whether a test called the “Oncotype Dx” may be helpful in making the decision about chemotherapy. This is a test that can be done on the cancer that was already removed and can help estimate the risk of future recurrence somewhere else in the body and whether chemotherapy is likely to reduce that risk. The test is most proven for cancers that are both estrogen receptor-positive and lymph node-negative.

[cats05]

A related discussion, survival rates at 10 years for stage 1b or 2a breast cancer grade 1 was started.