pathology results in chemo decision
 

Hi Friends,
I finished my 7th and last round of neo-adjuvant TCHP May 1st. So glad to be done but now results from surgery came back and I'm given the choice of whether to do 3 rounds of FEC chemo before radiation. I had 1 sentinel node positive for cancer and a 2nd sentinel node negative and a secondary node negative. They had clear borders from the lumpectomy.

What would you do? The node had very lacy cancer in a 2 mm tumor, only about 5% of active cancer in that tiny tumor. My original breast tumor was large, 6cm, er pos and HER2pos. Part of me says, yes, do the additional chemo and do all I can to lick this thing the first time out. The rest of me says, no, we still have 6 months of Herceptin, 6 weeks of radiation, and 10 years of hormone therapy coming up. Advice welcome.

Re: pathology results in chemo decision
 

Hi Liz, if its only three rounds I'd be inclined to do it, that way you know you've done all you can and thrown everything at this first time around, I think otherwise you may second guess the decision for a long time, just my thoughts!

Re: pathology results in chemo decision
 

Lizb,
I just had my mastectomy on June 11th, left hospital on Friday. I am still waiting for my final path report. I have already had chemo. But if my oncologist said I would need a bit more then as bad as I wouldn't want to do it I would. After all we have come so far already. And I don't ever want to ask what if....

Re: pathology results in chemo decision
 

I try not to think about what is ahead of me and just get through the now. I've had 4 rounds of AC, went through 6 rounds of paclitaxel to find I couldn't tolerate it and have had to start again now with Docetaxel. I was due to be finished all chemo by end of June but now my end date is out to August. Then I need radio if my genetic testing is negative. Not thinking about what happens with a positive result yet. So I just have a sip of concrete, toughen up and get through it. I'm having a terrible time at the moment with the Decetaxel but I'm just counting the treatments down. I think of this as just a year I have to get through of chemo, radio and surgery and then it will be plain sailing with herceptin and tamoxifen. I also don't want to be sitting around in a few years if it comes back thinking God why didn't I just do it back then.

In saying that it's a very personal decision so you have to go with what you can tolerate. Not sure I could do it without my awesome family so just do what you think is best.

Re: pathology results in chemo decision
 

hmmm that's a hard one. Seems you got standard of care up front. I didn't know they were doing chemo after if you had less then a complete response. I think its smart actually - the whole point of neoadjuvant.
if you were er/pr neg then I would say for sure do the extra chemo since there is no hormone therapy after. You are er positive so you still have hormone therapy and Herceptin.

I would get a second opinion for sure - this is not a standard protocol, maybe they can do a gentler chemo after instead?

that being said I did 3 rounds of FEC and if you control the nausea its not so bad

good luck with your decision

Re: pathology results in chemo decision
 

LizB,

If it were me, I would go ahead with the additional rounds of chemo. I know that chemo is brutal but it is also brutal for the cancer, which of course is a good thing. It is a personal decision so you will need to do what you feel comfortable with. For me, I know that if I declined the treatment and the cancer came back I would always wonder if it was due to refusing the additional rounds of chemo.

Make a decision that you can live with now and in the future.