Why is it necessary to have chemo, radiation and hormone therapy after surgery? ISn't that overkill?

Dear doctor(s):
I was diagnosed with stage II breast cancer in early May. I chose surgery first and my tumor turned out to be 3.cm. There was a macromet (not certain of the exact term) in my sentinel node but otherwise I was node-negative. Pet scan and CT showed no cancer spread in my body. My tumor is estrogen and Progesterone positive and Her 2 negative. My tumor is high grade. First my oncologist suggested the Oncotype DX test and got my hopes up high knowing that this test shows whether one even needs chemo or not. I suggest that all newly diagnosed breast cancer patients go to this website before undergoing chemo to read about this newer test. The website is www.oncotypedx.com. It's sister site is www.MyTreatment Decision.com which profiles about 7-10 women who have undergone this test.
To continue with my story: my oncologist changed her mind about ordering the oncotype dx test for me when she discovered my tumor was 3 cm. and a tad of cancer showed up in the sentinel but no other nodes. She told me that it was a longshot that I would get a low score on the oncotype dx. But then, after I returned from vacation, three days before my first chemo treatment, her office calls to inform me that the coverage of my oncotype dx test was approved by insurance. (I was not even informed that the doctor ordered it in the first place. She scheduled me for chemo and that was that.) Then two hours later I get a call that the test has actually not been approved but rather under review by the board and it would take 5 days or more to approve or disapprove it. What gives these doctors the right to play ping pong with the emotions and minds of vulnerable patients trying to make treatment decisions? My husband and I said we would pay out of pocket and to please begin the procedure-- the oncotype dx takes 9 to 14 days or so to get the results. My doc's office said no to out-of-pocket pay-- that they still needed pre-authorization from insurance before they could conduct the procedure.
My questions are: should I seek another opinion-- someone who will do the test out ot pocket? Do you think my results would be a longshot, as my dr. claims, considering the above factors I mentioned? Even with some of these factors-- such as grade and size of tumor-- what is the point of undergoing all three treatments? Can I opt for radiation and hormone therapy and skip the chemo since my oncologist only wanted me to have 4 chemo sessions over 12 weeks anyway? Can I still lower my reoccurence rate with just radiation and hormone therapy? I already had the surgery and the tumor removed a month ago. Why is this doctor going back and forth with me--- ordering chemo, then ordering the oncotype dx test? Sorry for the sleu of questions but I am confused about the next step to take here. Most 20 year breast cancer survivors I know of had mastectomies and tamoxifen and never any chemo so what's the deal here? Why all three forms of treatment?
Nancy


This discussion is related to Is Chemo necessary for early stage breast cancer?.

[japdip]

If you are as uncertain as you seem by your writing I would advise you to seek that second opinion. Having said that, the treatment recommended Surgery, chemo, Radiation, Hormone Therapy is certainly the accepted plan for your particular circumstance. Your tumor was certainly over 1cm and there was a positive node (even though ? slight) and your tumor was ER, PR +. We have the right to accept or refuse any treatment that is recommended .... but I wouldn't advise it. If you really aren't 100% comfortable with the way your Oncologist is handling your case then get the 2nd but I'd do it right away so you can get started with your treatment. Best Wishes..

[japdip]

One additional comment ... NO, it is not "overkill", it's Good Medical practice.  
Once again ... Best Wishes.