oestrogen and DCIS

Hi All,

The decision is on me, my oncologist give me 2 set of treatments, 
chemo + rad .....
or
rad + shut off the ovaries while waiting the ovaries surgery(due to covid i assume) they will do implant every 4 weeks (inject ovaries from my tummy with something i heard ...no idea how long the needle ...make me anxious)

then hormone therapy after radiation.


LVI is Lympo Vascular Invasion, since they found cancer in blood cell and my cancer is grade 3 aggressive...this make me have to choose chemo or not
but
i forget to ask, I just thinking that if I choose Radiation and they shut down my ovaries since this cancer is hormone sensitive (ER+7/8 and PR+8/8) no idea what the number for ...
then If I do regular check up on my breast USG and mammo after the radiation as precaution if cancer recurring, this would be ok as well ...so no need chemo...

or the cancer might jump to another place in my body ??? since it has is my LVI ???
Clear lymph node does not mean 100% free cancer .... since the cancer can go via LVI my blood.

I have no idea whether I am thinking is right or not ?


many thanks

@Della

Here's a link to a post that speaks of LVI

Hope it helps!

https://onlinenetwork.bcna.org.au/discussion/17811/focal-thin-walled-lymphovascular-invasion

@della.  I am not sure what LVI is ... maybe check with your Onc/Breast Care Nurse.

The margins is getting ‘clean flesh ‘ as well as the tumour, so they can confirm that they got all the tumour as well as surrounding clean flesh.  The pathology report should indicate how much clean flesh was removed ( usually in mm’s). Ask your breast care nurse to check the margins - tho if they weren't 'clear' you would have been advised by now & possibly gone back for further surgery. So I am guessing that isn't something you need to worry about. 

Yep, as @Fraser said - the role of the chemo is 'mopping up' any randoms that may have escaped ... hubby only had 1 positive node (out of 30 tested) and he still had chemo 'just in case'.  I reckon with this disease, you don't want to be asking later on ... 'what if' ..... you've gotta chuck everything at it that you can .... so with discussion with your Onc, you'll work out a plan.

I only had radiation (chemo was never put on the table with me) so I was one of the lucky ones.  

take care & all the best xx

Hi it is all a lot to take in but there is a certain extent to which you have to trust your medical team.
My own story was that I had a large (5.5cm) lobular tumour in my left breast which had not spread to my lymph nodes and it was ER positive, grade 2.
I was recommended radiotherapy because of the size of the tumour but not chemotherapy and I took the advice.
I decided in the end to have a double mastectomy and DIEP flap reconstruction.
There is a wealth of information on this website and no question on this forum is too silly , we have all been there in one way or another.
when you get through the surgery ( or even before if you have time) have a listen to the Dr Charlotte Tottman podcasts I found them really helpful for the psychosocial aspects of breast cancer.
I am now 12 months post diagnosis and 3 months post the DIEP surgery and getting more back to my “old self “ ( although I will never actually be that  person again) every day, so there is light at the end of the tunnel!

Chemo is a ‘sweeper’ of the body - it’s job is to kill any cancer cells that are circulating. Surgery and radiotherapy are targeted, they affect specific parts of the body. But chemo affects all of the body. Which is why it can be unpleasant. Reactions to chemo vary a lot. Some people have very strong reactions, including nausea and fatigue, others (like me) fairly mild reactions and it’s almost impossible to know which, until you start. Hair loss (temporary) however is common. Your oncologist is best placed to advise on how significant chemo might be but the choice is yours. Chemo isn’t a lot of fun but you will have the knowledge that you have done everything possible to avoid a recurrence. Best wishes. 

Hi All,

I have seen my oncologist this afternoon.
I have 2 options, chemo + rad or rad
Chemo is like life insurance or house insurance to protect the cancer recurring.
I am confused...
I dont want the chemo but without it the cancer might recurring ???? 
I dont know what to do...
Chemo is an option since they found that some cancer already in the blood vessel - LVI . this is new term for me.
and my cancer is grade 3
my cancer is small 14mm, ER/Pr positive Hers2 negative and 2 lymph nodes are clear.
@arpie, you mentioned about margin, is it the LVI ?

thank you so much @iserbrown for the link, do you have link related to diet food for having this hormone ER/PR receptor. I love to eat tofu and soya bean milk and others beans but since they have highest estrogen, this will feed the cancer to grow....

@StrongCoffee, surgeon mentioned genomic testing as well since my parents' history - has cancer and cirrhosis. but the decision is from oncologist team she said.

many thanks,

It sounds like they're recommending you for genetic testing not genomic testing (which is what I had) if it's HBOC. I don't believe this will impact on their treatment decisions.
An endometrial ablation is where they "burn" away the endometrium of the uterus. I had it done due to low iron from heavy bleeding. There are other hormone medications that may be more suitable if you have a uterine cyst. Your medical oncologist can help to explain all the options and the different side effects.

Good to hear that you have antibiotics already. Definitely take the full course, it won't cause any harm if you don't have an infection but will be well worth it if you do.

"Hormone therapy | Breast Cancer Network Australia" https://www.bcna.org.au/understanding-breast-cancer/treatment/hormone-therapy/

Not sure if you have seen this link.  

So much to take in

Take care