Breast cancer and chemotherapy

[scouch01]

I was diagnosed wiht stage one breast cancer in March.  It was invasive ductal carcinoma. The tumor size was .45 mm but poorly differentiated, grade 3.  I chose to have a bi-lateral mastectomy due to family history and the fact that I'm BRAC2 positive.  My oncologist sent for a Onca test to be performed in order to determine if I needed chemo or not.  The onca test came back but with no results because they said there wasn't enough cancer tissue to perform the test.  When I first met with oncologist I was told I probably wouldn't need chemo but now with no test results she is telling me I should have chemo.  What do you think?

[Cleveland Clinic]

Dear scouch01, Adjuvant therapy is treatment given after surgery to try to prevent or minimize the growth of microscopic deposits of tumor cells that might grow into a recurrent tumor. Adjuvant therapy may be hormone therapy, chemotherapy, or radiation therapy to the site – or a combination of any of these. Decisions regarding recommendations for adjuvant treatment for breast are based on several factors such as hormone receptor status, Her2 status, tumor size etc.   The Oncotype DX assay (if that is what you are referring to by Onca test) may provide more individualized prognostic information that can be helpful in deciding whether chemotherapy should be given in addition to hormonal therapy.   Without this result as another aid in the decision making recommendations would be based on what is known as the risks and benefits in your individual situation.  These (risks/benefits) are best discussed with your oncologist who can put them in context of your situation.

[scouch01]

I forgot to include that I am ER+ (Percent Positive 100) and I thought I was PR neg but on my path report it says 36 percent positive (whatever that means) and also HER2 neg (Fish test).   My tumor was 4.5 mm not .45mm.  I was also node negative.  I had good margins.  My surgeon told my family after surgery that it was so small she had trouble finding the tumor with the naked eye.