suggested treatment

recent lumpectomy performed on right breast-2.5cm stage 2 node negative.  clean margins achieved.  strong positive estrogen receptor and weak positive progesterone receptor--her2neu negative.  infiltrating lobular nuclear grade 2--what is your suggested treatment for this case?

[CCF-RN-JS]

Dear stucc:  Decisions about adjuvant chemotherapy or hormonal treatment are based on several factors including the status of lymph nodes under the arm, size of the cancer, the appearance of the cancer under the microscope, as well as the presence or absence of hormone receptors for estrogen and/or progesterone, the general health of the patient etc.  We can not make specific treatment recommendations for an individual in this forum. We can tell you that antiestrogen treatments are frequently given following surgery for ER-positive breast cancer to reduce the risk of recurrence in the form of metastatic disease. Chemotherapy will often add a modest additional benefit that needs to be weighed against the potential side effects. You should discuss the options with your oncologist. You may also want to ask about the Oncotype Dx assay that is sometimes used to help with treatment decisions in hormone receptor positive, lymph node negative breast cancer.

[stucc]

thanks--they are planning on radiation and an estrogen blocker--optional chemo--i just wondered what the overall benefits would be if it is not in my lymph nodes? plus if i would opt for it i know it is toxic to good cells too--is it really necessary?  

[boninclyde]

I wonder why they did not do a lymph node biopsy. This size of breast cancer they should check your lymph nodes. At  2.5cm they usually recommend chemo. Always get second opinions.

[Twocapes]

Your breast cancer sounds just like mine three years ago.  It was surprising to find out the size - 2.5 cm - since I was followed so closely having had seven benign biopsies in the past 30 years and a mother and aunt with breast cancer.  Anyway, I had the lumpectomy, sentinel node biopsy which was negative, and did the chemo (AC) and radiation.  I wanted to have every possible percentage in my favor for non-recurrence.  I have also been on Arimidex as my estrogen receptor was high (98%) too.  Lots to think about and decide - Good Luck.

[stucc]

thank you all for your comments and interest--i did have a sentinal node biopsy and it was negative....which leads me to question the need for the chemo???

[boninclyde]

Visit breastcancer.org. The discussion board there. Maybe their input can help you. Allot of ladies there have had to make the same dicision.

[BAMBI40]

Hi there:

I had my breast cancer 6 years ago.  I had a lumpectomy which revealed a 2.5 x 2.7 cm cancer that was very aggressive.  I had to go in for a second surgery to remove more tissue in the surrounding area and lymphnode disection.  My lymphnodes were negative for cancer and the extra tissue removed was negative for any cancer cells.  I had to have 4 1/2 months of chemo and 16 treatments of radiation.  The reason for my therapy was because my cancer was invasive, which means it was exposed to the blood stream.  The milk duct had broke open, because it was no longer able to hold the growing cancer, which exposed cancer to the blood stream and increased my risk of getting it somewhere else.  That was the reason I was given for doing the treatments.  Your treatments for cancer will be based on the size and grade of your cancer, if it was invasive or insitu, and if it was ER negative or positive.  I asked the cancer centre for a copy of my report which helped me better understand what was being done and why.  I was told that because mine was agressive they were treating me aggressively.  It has been 6 years and I am still going strong.  I wish you luck.

[stucc]

bambi--thank you for your encouraging words!!
my path report came back friday from the lumpectomy and said clear margins, medial and deep...no lymph nodes,stain for micromets was negative...very positive meet with radiation onc and onc this coming week...

[stucc]

can some one explain what this means?  chronic inflammation with foreign body giant cell reaction of biopsy bed-no evidence of malignanacy.

[boninclyde]

Try posting the question to the doctor above. We only get 2 questions a day so early mornings is best to try.