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Breast Cancer (Expert Forum)
Is Chemo necessary for early stage breast cancer?
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.
Is Chemo necessary for early stage breast cancer?
by kkidd, Oct 20, 2006 12:00AM
Dear Sir,
I met with the medical oncologist today and was told that I need chemo. He is the first doctor who suggested chemo. Three surgeons read the same report (please see below) and told me it’s early stage and all I need is surgery and radiation. Had lumpectomy at the end of September, margin is clear, lymph node is negative.
His reason for chemo is:
1) Cancer cell from pathology report is poorly differentiated
2) I’m still young (if 50 is still consider young?). Cancer might spread to other body part in the future
3) He doesn’t consider my case as early stage; his definition of early state is DCIS.
POORLY DIFFERENTIATED INTRADUCTAL COMEDO TYPE CARCINOMA WITH HIGH GRADE 2 MODIFIED SCARFF-BLOOM-RICHARDSON (TUBULE FORMATION 3, NUCLEAR PLEOMORPHISM 3, MITOSES 1).
ER: unfavorable at 0%
PR: unfavorable at 0%
HER2-NEU: BORDERLINE at 1.8
Can you please help me to understand the report, why does the three surgeons think it’s early stage and not necessary to have chemo? Should I see another medical oncologist?
Thank you for your time.
I met with the medical oncologist today and was told that I need chemo. He is the first doctor who suggested chemo. Three surgeons read the same report (please see below) and told me it’s early stage and all I need is surgery and radiation. Had lumpectomy at the end of September, margin is clear, lymph node is negative.
His reason for chemo is:
1) Cancer cell from pathology report is poorly differentiated
2) I’m still young (if 50 is still consider young?). Cancer might spread to other body part in the future
3) He doesn’t consider my case as early stage; his definition of early state is DCIS.
POORLY DIFFERENTIATED INTRADUCTAL COMEDO TYPE CARCINOMA WITH HIGH GRADE 2 MODIFIED SCARFF-BLOOM-RICHARDSON (TUBULE FORMATION 3, NUCLEAR PLEOMORPHISM 3, MITOSES 1).
ER: unfavorable at 0%
PR: unfavorable at 0%
HER2-NEU: BORDERLINE at 1.8
Can you please help me to understand the report, why does the three surgeons think it’s early stage and not necessary to have chemo? Should I see another medical oncologist?
Thank you for your time.
Doctor's Answer
by CCF-RN,MSN-JS, Oct 20, 2006 12:00AM
Dear kkid, Decisions regarding recommendations for adjuvant treatment for breast cancer (treatment given after surgery to try to prevent or minimize the growth of microscopic deposits of tumor cells that might grow into a recurrent tumor) is based on several factors. Even if it is an early stage cancer considering the size of the tumor, other features of the tumor may increase concern for spread of cancer. Some of these features include; what the cells look like under the microscope, grade of the tumor, hormone receptor status as well as HER2-Neu status. A medical oncologist would be the appropriate specialist to discuss with you the risks and benefits of adjuvant chemotherapy in your individual situation.
Don't wait a long time to decide whether or not to take chemo. The window is only 12 weeks between surgery and chemo to get any benefit. If you have the time, have your oncologist order the Oncotype DX test. Post back if you aren't aware of this. I'll give you more info.