Treatment options

I'm looking for opinions on treatment options for my Mom, who just turned 70.  She had a lumpectomy at the end of October.  Pathology results are:  grade 3 invasive measuring 2.5 cm by 1.7 cm.  ER/PR receptive.  No spread to lymph nodes (based on sentinal node biopsy) and no spread to other areas based on bone scan/x-rays/ultrasounds.

We are waiting for results of HER2/neu test.

She had a heart attack 2 years ago, but no muscle damage and no angioplasty required.  She has been on thyroid medication for over 20 years.

Oncologist has recommended radiation (16 doses) and arimidex for 5 years (she could also choose tamoxafin).  

If HER2/neu is positive, oncologist recommended chemo of A/C (6 treatments, 1 every 3 weeks).

If HER2/neu is negative, oncologist said she could choose whether to do chemo or not and which one -- either A/C or CMF (which would be 6 treatment over 6 months.)

Are there other options that she should consider, or factors that she should ensure she considers in making her treatment decision?

Thanks in advance for your response.  This is a great site -- I've learned a lot from reading the Q&As over the past few weeks.

[CCF-RN,MSN-JS]

Dear ridley, 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.   Some type of adjuvant therapy would be recommended with a tumor greater than 1cm in size, regardless of whether the lymph nodes were positive or not.  Positive Her2/nue status is a indicator of a more aggressive type tumor thus the recommendation for chemotherapy for sure (AC is standard).  Another factor that will be taken into account when determining chemotherapy choices (AC or CMF) would be your mother's overall health and cardiac status.  If your mother's heart showed damage (they check heart function before giving adriamycin) they may recommend the CMF regimen which does not have the heart toxicity that adriamycin (the A in AC) does.  Heart toxicity is a rare side effect of adriamycin.

Hormone therapy Arimidex or Tamoxifen would be recommended regardless if she takes chemotherapy or not because her tumor is estrogen receptor positive.  

Radiation therapy will also be done regardless, to treat the rest of the breast.


Hormone therapy will

[rkmsim]

My mother was diagnosed with breast cancer last year at age 80.  Her pathology report was just about identical to that of your mothers. Her oncologist recommended A/C chemo and she did 2 treatments but became so ill from it that she ended up in the hospital.  She and I (I've had breast cancer twice) both told the doctor no more chemo. She had radiation with no problems and is now on Tamoxifen.  Different oncologists have different opinions.  When I told my oncologist about her case he couldn't believe that they would put her on chemo at age 80 with clear lymph nodes and ER/PR positive receptors.  Of course your mother is 10 years younger.  Quality of life has to be a factor which is why I decided against chemo the second time even though my tumor was 1.1cm with clear lymph nodes. I suggest you get 2 opinions before deciding what to do.