Forum Discussion

TCH's avatar
TCH
Member
10 months ago

? Chemotherapy

Please HELP!!

Hi everyone, i am 45 years old and i have recently been diagnosed with;

ER positive 
Ki-67 positive
Tumour size 12mm
Toumour has been surgically removed 6 weeks ago with clear margins from right breast.
Tumour grade 3
2 x Negative nodes

I was told that i need radiation therapy and endocrine therapy. But i was given the option to decide if i want to have chemo as well! I am really struggling with making this decision whether i should have chemotherapy or not. Or do i just do Radiation and endocrine therapy. I was wandering if anyone has been in similar situation as me and how did they decide on treatment plan?

12 Replies

  • Hi TCH- that sounds like a difficult decision. My situation is a bit different as the oncologist recommended chemotherapy for me (stage 2; grade 2/3; premenopausal). She was able to see on her computer the likely survival benefit chemotherapy would give in my situation and it was over the threshold where she would recommend chemotherapy. It may be worth discussing at your next appointment if you have not already done so, the likely benefits and risks in that situation in more detail to see if that would assist. I was also offered oncotype testing but decided against it as in my situation it would not have changed the treatment. Perhaps in a case like yours, it would be worth considering that test to get more detailed information on the risk of recurrence to help inform your decision. Wishing you well with your treatment :)

    • TCH's avatar
      TCH
      Member

      Thank you for your response that’s great advice :) 

      My breast predict was;

      surgery only 82%
      +hirmone therapy (4.4%) 87%

      +chemotherapy (2.2%) 89%

  • Hi there TCH​, What was you ki67 number? Mine was very high and unfortunately even though I had chemo, the cancer metastasised 3 yrs down the track. My original bc was ER and pr positive, her2 negative, grade 3 cells, 17mm tumor, no lymph involvement but ki67 was at about 70% so very high. I had a lumpectomy with clear margins, radium, chemo and hormone suppression but just bloody unlucky with it metastasised 3 yrs later.

    Ask some more questions about your risk profile and likelihood of return so you can weigh it all up.

    I wasn't really given a choice on chemo but I was advised it was my best chance and actually when I was diagnosed with metastatic disease my oncologist was shocked as she said she thought i was over treated with my original bc.  I think that ki67 factor and the grade3 cells are important factors in considering treatment options.

    • TCH's avatar
      TCH
      Member

      Hi Cath and thank you for your response. My Ki67 show staining up to 80%. So that’s pretty high isn’t it! So many factors to consider!

      I am so sorry to hear that for you. It’s all so scary and overwhelming 😞 i wish you all the very best and good luck 🫶🏼

  • Hi TCH​ the early days of diagnosis can be overwhelming, don't be afraid to ask more questions if you feel you need to before you make decision.

    My diagnosis was similar, IDC 20mm er pr + her2- ki67 30%, grade 3, but I also had 1 lymph node involved.

    My oncologist strongly recommended chemo, so I decided to do it.

    My treatment was lumpectomy, chemo, radiation, hormone therapy and abemaciclib for 2 years. 

    All the best for your ongoing treatment.

    • TCH's avatar
      TCH
      Member

      Thanks for sharing Katie i appreciate it. It is so overwhelming. I just want to be in a position to make the right decision based on the right information i guess. 
      All the best to you too.

  • HiTCH​ 

    good luck with your decision making. The network folks have already shared some helpful information. In my case the recommendation made to me for my cancer type (HER2 positive, ER+ and PR+) was very strongly for chemotherapy, lumpectomy and  radiation.
    After listening to the data from relevant trials I also found it helpful to understand that having chemo might help eliminate cancer cells present in any “distant sites”. 
    A big part of my decision was probably more of a gut reaction and to take as big a swing as I could with the available options in my first treatment. 
    Wishing you well as you make your decision. 

    • TCH's avatar
      TCH
      Member

      Hi Tri, thank you for your response. I totally agree, i am hoping that every interaction and every research will help me and bring me closer to making my decision. 

      Thank you for sharing i appreciate it and all the best to you too.

    • Teta's avatar
      Teta
      New member

      Hi Tri​ ,

      I'm newly diagnosed and in a similar situation to you - curious to know 10 months down the track which path you decided on? 

      • Tri's avatar
        Tri
        Member

        HiTeta​ I'm sorry for your diagnosis- it is a real downer. Hope your doing ok.

        My diagnosis was 3 years ago and I went onto the option of chemo first, surgery (lumpectomy) radiation therapy, chemotherapy and immunotherapy and hormone therapy. There’s many variations in breast cancer type and we each have our own health and age or stage that our doctors consider and which we think about, but I think the plan I followed is fairly common for those of us who are in the Triple Positive breast cancer type. 

        I don’t have regrets about my treatment choices, so far, 18 months after completing the intravenous treatments surgery and all I am still “no evidence of disease”. A choice I could have made differently was to have a mastectomy but I took the lower impact surgical option. 

        The treatment plan took about 15 months from start to finish and I still on hormone therapy (oestrogen blockers) for another 7 years.

        The treatment is not a cake walk but it was manageable, I had a few different side effects each time but I do feel I have done what I can to be here. I am altered by having had treatment and still having treatment but I feel grateful to have had the benefit of being treated. I am now very actively engaged in work, travel, community, sports I enjoyed and life again. I understood from the medical advice that the statistics from trials were pretty solid and survivorship for HER2+ patients has been turned around by the treatment with better outcomes over the last decade.

        I am curious but ran out of time to have genomic or genetic testing - I was about to start chemo when I asked my oncologist and she more or less indicated that it was something I could do but with my breast cancer type (Triple Positive) it was unlikely to result in her varying her recommended treatment plan.

        I hope this helps. If you’re Triple Positive it’s good to know it’s less common than hormone positive, so friends of mine who’d been treated for Oestrogen or Progesterone positive breast cancer were puzzled by the treatment plan I had.

        Go gentlyTeta​ and sending positive energy your way.