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Stage 2/ grade 2 - is chemo required?

Annalyn Member Posts: 6
edited February 6 in Newly diagnosed

Hi all. I'm new here and just had my lumpectomy on 16/1/23. Reports mentioned 40mm tumour on right breast. Re-excision is required to obtain a clear margin and one lymph node is involved (has cancer) 🙁. Ki67 is 40%-50% and I'm ER+ and PR+. Oncologist mentioned I need chemo as one lymph node is involved however after reading this forum it may not be the case. I am 44 years old. Can I refuse chemo and still be safe ? I feel so lost 😞 


  • Cath62
    Cath62 Member Posts: 1,130
    edited February 7
    Hi @Annalyn, it's all so overwhelming trying to figure out the best treatment. The ki67 factor nearing 50% and your grade 2 status of your cancer cells is probably why chemo is recommended especially since one lymph was involved.

    If one lymph was involved in then only takes one cancer cell to take off and get to another organ and so chemo can hunt those cells down and cancer is then killed off  I would get the chemo and you will have more peace of mind that your cancer is actually all gone. If no chemo that cancer that went to the lymph can have spread and it can spread fast. 

    I was 57 when diagnosed with stage 1, grade 3, ki67 at 69% and ER and PR+. I had surgery, chemo x 4 months snd 20 rounds of radium and now AIs. I got through it all. That was in 2020. Yes it was hard at times but it is doable. 

    You can do this too. One step at a time. Reward yourself after each treatment with a night away or a night out for dinner. I hope you have some good support  to help you at home. Best wishes to you 
  • Annalyn
    Annalyn Member Posts: 6
    Thank you for your response. My fear at the moment is the port placement as I have difficult veins and prone to keloids and hematoma. Actually I'm scared of the entire process. I am now waiting to see the medical oncologist to discuss the next step ie chemo . Second surgery will be post chemo. 
  • AllyJay
    AllyJay Member Posts: 926
    Regarding your fear of the port placement, I can share the following. Prior to being diagnosed with breast cancer in 2016, I had been on blood thinners (warfarin), for almost twenty years. This requires very frequent blood tests to check my clotting levels and had resulted in extremely scarred veins from the repeated blood tests. I had my port put in on the morning of my first AC chemo session using a local anaesthetic. I still have my port...this September will be 7 years and it is frequently used for the contrast in scans (it is a Power Port-a-cath and can take the pressure that the contrast is injected in). I have other significant health conditions which result in me being in hospital on a fairly regular basis. There it is used for IV fluids as well as blood tests. None of the regular pathology clinics where bloods are taken have staff who are 'port certified' and there they have to play 'hunt the vein'. Even in hospital, not all registered nurses are port certified, but they can be located if I put my foot down and insist on my port being used. I have mine flushed and Heparin locked every 6-8 weeks to keep it viable. It has never become infected, flipped, kinked or misbehaved in any way and it will remain there as long as it continues that way. When and if it causes problems, it will be replaced by another on the other side of my chest. As far as pain when being accessed is concerned, I get more twitchy when having a finger prick to check for blood sugar levels.
  • Cath62
    Cath62 Member Posts: 1,130
    Hi again @Annalyn, are you sure you need a port? I had 12 rounds of chemo and no port. I had good veins and had a cannula inserted for each chemo session. It was fine. Just check your process and see what happens. Explain your fears and let them know how you feel. Best wishes 
  • Annalyn
    Annalyn Member Posts: 6
    People usually have difficulty finding my veins when withdrawing bloods. Had 2 anaesthetists using the ultrasound machine and also required 3 jabs each. So scared 
  • Julesuptree
    Julesuptree Member Posts: 5
    Hi @Annalyn I have a similar HER2+ oestrogen pos, progesterone neg and Ki67 50% and have had weekly chemo for a month now and I had the same fears as you. I'm also type 1 diabetic to boot and always dread blood tests as my vein aren't great, but the oncology nurses are amazing at finding veins and have lots of tricks - like a warm water bath for your arm before hand. I am still working as a produce grower for chefs and I told my nurse yesterday that chemo is nothing like in the movies. She said "darling, it was we are not doing our job properly". Everyones experience is different, but trust your team and so far I've found the whole experience not as I feared. Stay strong and allow yourself to be cared for and nurtured and supported by your team. Big hugs, Jules xx
  • Afraser
    Afraser Member Posts: 4,190
    Agree with @Julesuptree, general
    practitioners including nurses can be remarkably poor at hitting a vein, but oncology nurses are usually very good and much more understanding. I had six months of chemo, half of that weekly and could only use one arm as I have lymphoedema. Nurses were great, my senior nurse was particularly adept! But a port is also an option. Best wishes. 
  • Abbydog
    Abbydog Member Posts: 428
    Dear Annalyn,
    Try not to be too anxious. We are all different, and your Journey may be far better than you are anticipating. I had Mastectomy, Chemo 20 weeks, Radiotherapy 5 weeks. I did not work during all of this as I used my Income Protection Insurance. However, I did not have any serious complications through out all of these treatments. I had a Port for my Chemo. And in hind sight, I am even more grateful. I had an Axillary clearance( with that you need to take care of that arm) So now when I have blood tests and surgeries etc, the veins in my other arm have not been wrecked. I don't think that there will be anyone who can say you will be safe if you refuse Chemo. You could be safe. But I would rather have as much treatment as was recommended. So at least I had done all I could. I would get a second opinion from a qualified Oncologist. Each of us on this forum have similar stories, but they are also different.
    All the best with the treatments you go ahead with.

  • Arn_007
    Arn_007 Member Posts: 17
    Hi @Annalyn,

    Age also plays a factor for chemo so it, along with the other factors mentioned, could tip you over into chemo.

    I've got a port.  I was scared to have one as I hate the idea of a foreign body in me.  Now that it's in, I still think it's a gory concept but I wouldn't want it any other way (I'm not paid by PowerPort btw...).  The fentanyl twilight they give you is a nice nap, too.  Still, it's absolutely your choice and your unique medical circumstances, so no judgement here.

    Best wishes.  The ladies here are such a great support.