chemo or no chemo?

[outnumbered]

I hope I am in the expert forum...

June 24 had the excisional biopsy.  Findings were that I had a triple negative, High nuclear grade, high prolifertion rate DCIS and IDC.  I am also BRCA1 positive.  I am 40 years old, had all 3 children before age 30 and nursed them all.  The DCIS was 1.6 cm, the IDC was 2 mm.
I had a nipple preserving bilateral mastectomy on 8/5/08.  The pathology on the mastectomy was clean. Sentinel node bioopsy was clean.   I have expanders and expect to receive the silicone implants in Nov, or Dec.  I plan on scheduling an oopherectomy when I am recovered from the reconstruction

As of right now, I have been told chemo is not indicated.  Benefit does not outweigh the risk.  I have mild auto immune issues (unspecified connective tissue) and pre-menopausal osteoperosis.

Do you agree no chemo?

Thanks!

.  

[outnumbered]

Thank you for your comments.  Just to clarify, the oopherectomy is to prevent ovarian cancer due to my BRCA1 status.  

Thanks again!

[PaulMD]

Hi there.

Your present tumor status is microinvasive disease (T1mic), and with reference to present guidelines, chemotherapy is indeed not indicated (per National Comprehensive Cancer Network or NCCN  guidelines).  I believe that additional chemotherapy will not give additional benefit since it is also unlikely that your present tumor status would lead to systemic spread.

however, I believe that additional treatment may still be warranted in the form of radiotherapy to the breast.  You can have this before or after the final breast reconstruction.  If the tumor is triple negative, I doubt if the oophorectomy can be of benefit.

Regards.