Hormonal Therapy

[barbarann]

I was dx with breast cancer in November 07, had mastectomy on right breast in December.  The sentinel node was positive (2mm).  I am ER+ (100%) and PR+ (100%) and Her2 -. Bone scan showed no mets.  I am post menopausal (age 60).  My oncologist only recommended Tamoxifen for two years.  Do you think that because I also have MS (first sympton only four years ago) that his decision not to have chemo as well was based on this.  I will be going for my six month checkup in a couple of weeks and would like to know if this is something I should have asked before.

[BJSaws]

My oncologist said that the "rule of thumb" is chemo for tumors over 1 cm.  Mine was 1.1 cm and I had chemo.  However, mine was ER and PR negative, so the hormone treatments were not available for me.  Perhaps that is why chemo was recommended for me.  I would ask the oncologist just for peace of mind.  I'm sure his/her decision was based on what he/she felt was the best protocol for you.

[barbarann]

The stage was IIA and the size was 1.5cm.  My main concern has been that I had a positive sentinel node and from everything I have read most patients receive chemo as well as the hormonal therapy.  Since before the breast cancer, I had no post menopausal symptoms, no hysterectomy and was in pretty good health (except for the MS) and even with the tomaxifen I only have slight flushes one or twice a day, does this mean that the tomaxifen may not be working as it should.  

[japdip]

That could very likely be the reason ... if I were you I would certainly bring it up when you go for your ck. up. If that was his recommendation and you were OK with it initially I can't see any reason to have ask before. Personally I would like to know the reasoning though .... as no doubt you would too, so ask away. Best Wishes for your ck. up.

[PaulMD]

Hi there.

The decision to forego with chemotherapy is least dependent on you having MS.  It is more dependent on the specific stage and characteristics of the cancer.  The fact that your cancer is Her2 negative and ERPR positive means that this carries a good prognosis, and if the tumor is small and no lymph nodes were involved, post menopausal women may opt to just undergo hormononal treatment.  However, I suggest you ask your oncologist about more effective hormonal treatment for post menopausal patients in the form of aromatase inhibitors (femara, arimidex exemestane).  Regards and God bless.