Stage 1, Grade 3 Invasive Ductal Carcinoma

[RBP]

My mom has IDC, Stage 1, Grade 3, ER and PR postive, HER2 negative, no lymph node involvement. A lumpectomy with sentinel node biopsy was performed to remove the 1.8cm tumor and clear margins were obtained.  

Doctors recommend chemotherapy but do not insist upon it.  How do we evaluate this type of response to make a decision one way or the other?  Hormone therapy and radiation will be part of the treatment as well. Also, what should be done going forward in terms of scans, tests, blood tests etc. to make sure it hasn't come back?  
  

[Cleveland Clinic]

Dear RBP:  Without evaluation, we cannot make specific medical recommendations.  Your mother’s oncologist is best equipped to have the discussion regarding what treatments will be recommended, risks versus benefits, and follow up testing.  You may also see if there is a medical oncologist specializing in breast cancer in your area who may have additional expertise.  One question you may ask the oncologist is whether the oncotype dx test might be appropriate in your mother’s situation.  This test has been used in women with stage 1 or 2 breast cancer that is node negative and estrogen positive to attempt to predict the chances of recurrence and thus help to guide treatment decisions. The use of results from Oncotype DX testing have yet to be prospectively validated.  However, trials such as TAILORx are accruing patients and the results are therefore pending. A clinical trial in this setting may be most appropriate as use of this test is still somewhat controversial.

[duff0015]

It may be useful for your mother to get an oncotype DX test done on the tumor.  This would give her the statistical probability for a re-occurrence over the next 10 years.  Many oncologists are using this to determine who needs chemo and who benefits from just hormone therapy.  Good luck!

[sumanb]

This all sounds too familiar. Oncologists leave such imporatant decisions to patients. the quidelines for factoring oncotype in the treatment vary. My tumor sz was large but my oncotype came out zero that menas i have 3% reccurence chance. My oncologist was read y to start me on Armidex and skip chemo. When I tolld him my scond and third opinion guys are saying I need chemo then he said i will give you chemo if you want it. What kind of answer is that.  I am i kid in the candi store trying to make the decsion?

I think each hospital havs their own standards, If you were in some of the hospitals I went, 1.8 cm tumor, er/pr pos, her-ve no angiolypmhatic invasion, you would be home free if your ono score came out to be low (<18). I would definitely persue it. It takes 6 to 8 week. Meanwhile I'd aske my onco if you caould start hormone thrapy, so that you are doing something. Good luck