The kind of chemotherapy

[rozita]

My mother had a mastectomy surgery 20 days ago  after a biopsy that showed invasive: NOS type,grade III 2.5 cm .and insitu:comedocarcinoma .The report on the stomach area is normal.Microscopic diagnosis :Estrogen &progesteron receptors negative.P35 negative.C-erb-B2 strongly positive.Cathepsin D positive.The report after mastectomy:no remant of tumor was found.reactive changes in the site of biopsy foamy macrophages foreign body type giant cells,fibrosis,chronic inflammation.A typical ductal hyperplasia in other sites of breast.Nipple & skin free of tumor.5 of 5 dissected lymph nodes free from tumor.
You will be highly appreciated if let me know what kind of chemotherapy is suitable for her and in what duration,as the ancologist here said radiotherapy is not necessary.
Thanks a lot for your kind consideration and prompt reply

[CCF-RN,MSN-JS]

Dear rozita, Adjuvant therapy is generally recommended for her stage of cancer (Stage II - tumor greater than 2cm, negative lymph nodes, no evidence of metastasis).  Adjuvant therapy is given after surgery to try to prevent or minimize the growth of microscopic deposits of tumor cells that might grow into a recurrent tumor.  Chemotherapy would most likely be recommended for this, as her estrogen and progesterone receptors are negative. This chemotherapy is usually given as a combination of drugs, there is some variation to the specific drugs given and the timing of cycles, so her oncologist will discuss the specifics for her case.  The oncologist takes into account her specific situation -overall health, medical history, physical exam etc, to decide the treatment plan.  Treatment lasts four to six months in most adjuvant programs.  As she has had a mastectomy, lymph nodes are negative, and no remnant of tumor is remaining radiation therapy is not necessary.

[surgeon]

You didn't state her age; however, since her ER/PR receptors were negative, hormone therapy (tamoxifen) won't be useful. Therefore, the only choice is what are called cytotoxic drugs, which will have some side effects. It's somewhat of a grey zone, in that if the nodes had tumor in them, there's no doubt she's better off getting some form of chemo. With negative nodes, and with the other parameters you describe, her chance of cure with surgery alone is pretty high. But a 2.5 cm tumor is not small, and it means she's in a higher risk category than with a small tumor; many, if not most, oncologists would recommend chemo in her case. The exact recipe depends on a few things, but they are all within a certain category and don't differ much in terms of risks and benefits. The bottom line is you need to listen to what her oncologist recommends and why; ask what other options there are, and why he/she prefers the recommendation made. If your mother remains uncertain, it's appropriate to get another opinion.