chemotherapy for recurrent breast cancer

[Mary0327]

I was diagnosed in March with invasive lobular carcinoma in the right axillary area.  Eleven years ago I was treated for invasive lobular carcinoma of the right breast, with a simple mastectomy followed by 6 months of CMF.  I had the latest tumor removed on May 2.  Ten nodes were tested, including the sentenel node, and all were negative.  The tumor was 1.5 cm.  The tumor infiltrated into skeletal muscle, but there was no lymphvascular or perineural invasion.  The tumor was histologic grade 3, nuclear grade 2 and mitotic grade 1, for an overall grade of 2.  My oncologist has recommended 4 rounds of taxotere, followed by 30 radiation treatments, and then hormonal therapy.  I'm very concerned about having chemotherapy again, whether the possible benefits outweigh the dangers.  Can you give me any advice?  I am 60 years old, in good health except for slight damage to my aortic and mitral valves from rheumatic fever when I was a child.

[Mary0327]

Thank you so much for your advice.  My feeling has been that I should follow the recommendations of my oncologist, but my husband and daughters have been urging me to get a second opinion.  I really didn't want to see another doctor.  I feel much better about doing the chemotherapy now.

Mary

[PaulMD]

Hi there.

For a breast cancer recurrence, chemotherapy always gives a better benefit to risk ratio especially if you have a good functional status (generally asymptomatic, able to carry on with activities of daily living, etc.).  When receiving taxotere, inquire with your oncologist if you can be given prophylactic G-CSF.  These are drugs that can increase your white blood cell counts and prevent a side effect called "febrile neutropenia" (this is when you have fevers or infections brought about by low white blood counts).  Neutropenia is the most common side effect of taxotere but this can be addressed effectively.  I would also agree with your radiation treatment since there is some involvement in the muscle and this could decrease the chance of recurrence.  Be strong in undergoing your treatment.  Wishing for the best... God bless.