Forum Discussion
New Diagnosis - now to decide on Chemo
I am very new to my diagnosis and now after my Chemo specialist appointment I am even more confused as to whether to have chemo - any thoughts on this would be appreciated.
My breast cancer pathology is: multifocal Gr 2 infiltrating carninoma, no special type - 18mm & 8mm lying 8mm apart, no node involvement, DCIS present, Hormone receptors positive, HER2 negative, clear margins. I've had a lumpectomy and sentinel lymph node biopsy.
Now, I've been told that my 10 yr prognosis with no other treatment other than the lump removed is 84.2% using the Predict Tool, Radiation & hormone therapy would add 2.8% Chemo would only add 2.3% to that - maybe. Now considering Chemo was never mentioned in my initial specialist appointment, (radiation & hormone therapy were) I am having a hard time coming to terms with the addition of chemo to the mix.
It has now been left up to me to make the decision on whether I should have chemo or not. The chemo specialist wouldn't say one way or the other. My thought line (before the pathology results) was if I had the cysts removed, clear margins and my lymph nodes are negative, I wouldn't need chemo and it was never mentioned. I understand now that the cancer may of already sent out nasty stuff to the rest of my body to lay dominant.
On paper it seems such a small % as to the reason to have chemo, on paper I have read all the side effects and what to expect, but as everyone is individual this has only helped to even confuse me even further. And the even longer term effects can't even be forseen or considered.
Does it really come back to peace of mind, or are there any other considerations I haven't thought of as I am so new and am finding it hard tap into resources. I may be grasping at straws but any imput would be welcome. I do apologise if the is a common topic here but being new I thought would put it out there for myself.
Thanks,
My breast cancer pathology is: multifocal Gr 2 infiltrating carninoma, no special type - 18mm & 8mm lying 8mm apart, no node involvement, DCIS present, Hormone receptors positive, HER2 negative, clear margins. I've had a lumpectomy and sentinel lymph node biopsy.
Now, I've been told that my 10 yr prognosis with no other treatment other than the lump removed is 84.2% using the Predict Tool, Radiation & hormone therapy would add 2.8% Chemo would only add 2.3% to that - maybe. Now considering Chemo was never mentioned in my initial specialist appointment, (radiation & hormone therapy were) I am having a hard time coming to terms with the addition of chemo to the mix.
It has now been left up to me to make the decision on whether I should have chemo or not. The chemo specialist wouldn't say one way or the other. My thought line (before the pathology results) was if I had the cysts removed, clear margins and my lymph nodes are negative, I wouldn't need chemo and it was never mentioned. I understand now that the cancer may of already sent out nasty stuff to the rest of my body to lay dominant.
On paper it seems such a small % as to the reason to have chemo, on paper I have read all the side effects and what to expect, but as everyone is individual this has only helped to even confuse me even further. And the even longer term effects can't even be forseen or considered.
Does it really come back to peace of mind, or are there any other considerations I haven't thought of as I am so new and am finding it hard tap into resources. I may be grasping at straws but any imput would be welcome. I do apologise if the is a common topic here but being new I thought would put it out there for myself.
Thanks,
23 Replies
- Is your pathology your initial or final report? Sometimes other results take longer. Ask your oncologist or breast surgeon. Mine never mentioned Ki67. Someone else asked me. My rate was 69. I was her2+. It freaked me out a bit...but I realised that is the nature of her2 cancers and why I was having chemo.
- Ki67 is also called MIB1 in pathology in Australia.
- Thanks Primek, I can't see any of that on my path report. and Ki67 is not recorded at all. Yes agree in the long run it doesn't affect anything, it was just curiosity as many other women list their BC type with a stage.
- Staging in Australia is shown on pathology like T1N2M0....so this would mean tumour on stage one, 2 nodes, metastates nil. However tbey only report what tbey have as svans etc elsewhere.
For predict you only need size, grade, nodes and if Ki67 rate below 10 or above.
This might assist you in working it out. But try not to get to invested in which stage as 1mm can move you within stages and in reality little difference to outcomes.
Again it is a tool or guide.
https://breast-cancer.canceraustralia.gov.au/diagnosis/stages-breast-cancer
And fact sheet on pathogy
https://www.bcna.org.au/understanding-breast-cancer/treatment/surgery/breast-cancer-pathology/ - Another quick question - how to I tell what "stage" my BC is. I can see the wording grade 2 but not the stage, should it be on my path report. Ta
- Payne, I was expecting to go to the appointment and be told yes need chemo or no you don't. Not to be given figures on 10 year survival rates and be sent home to think about it. I really wish he had of just said yes or no. But here I am, so once again I am very thankful to have a forum like this to ask questions and get answers, thanks everyone again.
- Hi LeaAnneD, I remember similar dilemma so asked oncologist what would he recommend and he told me, so I just went with that. I was not capable of making any decisions at that time, especially on a subject which I knew very little about. I do remember those percentages being thrown about and I thought, well another 2% here and another 2% there, think Ill take it. My survival percentage was only 76% at time of diagnosis so was glad to add a bit on. Chemo was not without side effects but was doable and I have no regrets. I am just 12 months on. Best wishes to you.
- Oh...just realised my typo ..my cancer wasn't detected in a mammogram 5 weeks before feeling a lump..due to breast density.
I was 51 at diagnosis and they called me young. (Nothing compared to our sisters with young babies though) I would say that could be a reason for the offer. My risk of return in 5 years on predict wasn't much different at 5 years. The letrozole was the most important there. The big difference was the 10 year survival difference. It was significant.
So if you were 75 for instance, they might not think it necessary. You can write down questions and ask more. Your bc nurse may be helpful here also. - My husband had a similar dilemma after very early bowel cancer surgery - nothing, a light dose of chemo or 6 months worth. He went for the latter, he too wanted a reserve parachute! Chemo was strongly recommended for me (we all have a choice) but on my first chemo, my side effects were very light. Much more irritating on the 2nd. But (in my 60s) I worked throughout, and with a very easy to use wig, a lot of people had no idea I was having treatment. Bear in mind if the side effects are too hard, you can stop. There are unfortunately no guarantees, but knowing you have done all you can may (or may not) be important.
- Thank you lades for your comments, all your analogies are so valid. I'm still struggling with what was on my pathology that put chemo on the table when it was never mentioned before. Are they really just covering all the bases. I really need to reach deep inside myself and decide would I be comfortable with the decision if i decide not to go ahead. I have always considered myself to be a fit and healthy 56 year old. Eat well, weight train, etc etc.... guess these days its just not enough. Hopefully this will help my body with the side effects if I go ahead. I am at the stage where I am starting to realise how naive I was in the beginning. Now it's all starting to sink in. Thanks again
