I had a lumpectomy mid January and all went well. Clear margins, no lymph involvement, hormone positive, Protein negative, 19mm. BUT grade 3. the oncologist recommended 4 x AC followed 4 x Taxol dense dose followed by 16 ray treatments, followed by hormone. I was hoping to avoid chemo and my surgeon felt hormone treatment was my best option. So I am shocked to say the least. I am considering the Presigna genome test to help me make the decision about chemo. The oncologist says chemo will give me 4% more. Any advice appreciated. Have you tried the Presigna? have you done similar treatment?

Hi @Frances54 , I too was offered chemo, and had no nodes involvement. The stats they gave me though were it'd make less than 2% max difference to my 10 year outcome. If my nodes had been involved I would have had chemo. For me, the probability of damage to other body parts 100%, and the potential benefit was less than 2%. My parents and other family members have been heavy smokers, yet no-one is offering them chemo just in case they've got a lung / other cancer no-one can pinpoint. The other consideration I had was that we know our bodies build up resistance to medications and treatments. So, if I had chemo now, treating probably no cancer, what happens if cancer does return? what's the possibility/probability of chemo not working as well, or at all, because the cancer is now drug resistant?I wonder if the treatments are highly recommended or just offered, because no-one can say for sure that you don't have cancer anymore.It's a terrible place to be in, trying to decide. Best of luck with your treatment journey xx

Hi @Frances54It would be helpful if we got consistent advice from our medical team, wouldn't it? Sadly that doesn't always happen.When making these sorts of decisions where the percentages appear small, I think it pays to consider your own personality. None of us are keen on the idea of chemo and many have chosen not to have it when it's been offered. If you are the sort of person who is going to spend the rest of your life stressing 'what if' it's probably best to consider doing it. If you can afford the test, it's a good idea, provided you are likely to take what ever advice it provides.It's a very tough call to make. I had AC in 2006 and worked right through. I had a recurrence (none of this comes with any guarantee) in 2016 and had TC followed by rads and hormone treatment. it has not been a pleasant experience. You really can not tell what is going to happen so you need to trust the best advice you can get, and ultimately goo with your gut. Good luck. Mxx

Welcome to the Forum. Sorry to see you here, @Frances54 .... but you are at the best spot for good advice and a heap of support from those who've been there already.Where abouts are you (City/state) - we may have members nearby who can point you to various resources available to you.I was lucky & didn't have to do chemo ...... just surgery, rads & tabs for invasive lobular BC - but I was stage 2 ...... I can appreciate your concern & shock at chemo being put on the table as part of your treatment. Your health team will be making suggestions/decisions that they feel is the best for your long term health .... and the chemo is given as 'insurance' to mop up any 'randoms' that may have escaped .... @kmakm may be able to help re genome test?All the best with your ongoing treatment - be kind to yourself, accept the offer of any assistance along the way & take care xxx

Hi Frances. Welcome. I had a 16 - 18mm tumour, no nodes, ER+ tumour that was Grade 2 - 3. I had a lumpectomy, followed by TC chemo after a genomic test that indicated there'd be a curative benefit if cells had escaped and were looking to grow somewhere else in my body. I didn't have radiotherapy as I ended up having a double mastectomy for other reasons, and am now taking an AI.TC is usually given to women with tumours smaller than 20mm with no node spread.Chemo was not necessarily on the cards for me but exploring the option was warranted given my circumstances (click on my @name for deets). When the genomic test (Endopredict) came back a clear yes, on my oncologist's advice I went ahead. Not pleasant, very hard, but no regrets.You haven't said how old you are; younger people are often treated more aggressively as their cancers tend to be more aggressive.You might want to ask your oncologist why they are recommending this particular course of treatment for you as opposed to other ones. Ask what are the risk factors for permanent damage with this course of treatment. I'm not suggesting there are, but I think asking these questions are a good idea! Definitely ask what percentage increased survival stats would this treatment give you as opposed to others, reduced or none.It's a hard decision when there are grey areas. Ultimately you want no regrets. I tended to parse my treatment decisions through that filter. K xox

Hi @Frances54,Welcome lovely. Choices, choices and more choices with no diffinitive answers. That's how it goes pretty much the whole way along. There really are no guarantees with any of it unfortunatley. Mine was 19mm breast tumour + a 25mm node one + 4 smaller ones hanging out in there. I had the 4 x AC and 12 x weekly Taxol cocktail followed by 30 rads. My nodes were positive so the benefit percentage was up around the 11%. I ummed and aahhed about chemo and like everybody else it scared the hell out of me.While it's no walk in the park it's generally not quite as horrific as what our brains like to imagine at the beginning. Surgeons really should not be giving advice regarding anything other than surgery. Now you are shocked and no one needs that.You do just have to go with your instincts and being able to trust them is no mean feat either, there is always doubt. Perpetual confusion abounds as to whether or not you are doing "the right thing". It really is will you blame yourself if you don't and it returns or would you be content with your decision knowing you made the right choice for you at the time.All the best with your decision sweet. Whichever way you decide please know that you'll always find a great deal of support, plenty of shoulders to cry on and some laughs along the way on here.xoxoxoxox

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StarGirl
Member
7 years ago
@kmakm Adelaide
kmakm
Member
7 years ago
Possibly. Some of our questions are like rabbit holes you can disappear down like Alice in Wonderland I reckon. Maybe jot it down to ask your oncologist next time you see them.

Whereabouts in this wide brown land are you @Stargirl?
StarGirl
Member
7 years ago
Thanks @kmakm, that makes sense. I already had HER2+ MBC when they found I had a new ER+ PR+ cancer so I can see why it was never mentioned. Although I wonder whether it’s worth knowing the likelihood of the hormone positive cancer metastasising, even though I know the HER2+ one already has? Maybe a moot point?
kmakm
Member
7 years ago
@StarGirl The tests look at your specific tumour and its likelihood of metastasizing and therefore whether chemo would have a curative effect.

From breastcancer.org:

The EndoPredict Test... (is) a genomic test for people newly diagnosed with early-stage, estrogen-receptor-positive, HER2-negative breast cancer. Research suggests the EndoPredict test may be widely used to help make treatment decisions based on the cancer's risk of coming back in a part of the body away from the breast (distant metastasis) within 10 years after diagnosis. The

EndoPredict test provides a risk score that is either low-risk or high-risk of breast cancer recurring as distant metastasis. Knowing if the cancer has a high or low risk of recurrence can help women and their doctors decide if chemotherapy or other treatments to reduce risk after surgery are needed.

What are genomic tests?

Genomic tests analyze a sample of a cancer tumor to see how active certain genes are. The activity level of these genes affects the behavior of the cancer, including how likely it is to grow and spread. Genomic tests are used to help make decisions about whether more treatments after surgery would be beneficial.

@Frances54 I have no regrets for my decision. I never wanted to look back and think 'if only'. Chemo's not fun but it's doable.
Frances54
Member
7 years ago
Ouch, that sounds painful. How long ago? Hope youre going ok. I guess one of the things we have to do is our faith in our team. In my case surgeon said no to chemo, radiation oncol said maybe, oncologist said yes. Hence my second guessing which has caused a great deal of anxiety. I suspect there are a lot of factors they take into consideration which arent shared with us.
StarGirl
Member
7 years ago
Removal of all the lymph nodes
Frances54
Member
7 years ago
A genome test gives you more info about the characteristics of the tumour, costs a bomb. I had a lumpectomy so maybe thats why. I have to have three weeks ray and 8 cycles chemo. Whats axilla clearance?
StarGirl
Member
7 years ago
Hi @Frances54, I haven’t heard about a genome test and have no idea what it is. I had a mastectomy and axilla clearance and then did 5 weeks of radiotherapy.
Frances54
Member
7 years ago
If only they all got on the same page. Its cost me a lot of heartache trying to make the decision. I keep rethinking my position. I start chemo Thursday anyway. Ive never had it before so feeling anxious this week. The genome test came back high risk for recurrence so Im trying to tell myself I have no choice and have to do everything I can. What treatment did you have?
StarGirl
Member
7 years ago
Hi @Frances54, that’s really interesting. I had grade 3 tumours and lymph node involvement and no one even suggested chemo. Maybe because I did chemo previously? Now I’m beginning to wonder . . .