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05-02-2007, 03:40 PM
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#1
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Senior Member
Join Date: Jan 2007
Posts: 72
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No treatment beyond surgery
Anyone else have no treatment recommended beyond surgery?
I had a good amount of DCIS with a tiny bit of IDC (2 foci largest of which was .3 cm which was ER+/PR+/HER2+). Had lumpectomy w/ SNB (negative) which found and removed the IDC but no clear margins on the DCIS. Re-excision lumpectomy again yielded no clear margins on the DCIS. And finally told that mastectomy would be best. I opted for bilateral mastectomies. Margins on mastectomies were fine so no rads.
Oncologist isn't recommending any chemo due to really tiny tumor size. He isn't recommending hormone therapy since the cancer was node negative and both breasts were removed. He isn't recommending Oncotype testing because there may not even be enough tissue to test due to tiny tumor size. He is contacting Hopkins to get an informal second opinion for me. If opinion is different, he wants me to go consult with Hopkins. He said I can always go get a second opinion there or elsewhere if I wanted whether their opinion agrees or not.
Anyone similar?
Kathy
__________________
12/01/2006 Initial Dx via stereotactic biopsy - DCIS, grade 3
12/27/2006 Lumpectomy w/ SNB: 2 foci of IDC (largest .3 cm, Grade 2, Notthingham score 6) amid large area of DCIS: No clear margins on the DCIS; re-excision recommended
ER+(55%)/PR+(60+)/HER2+ (2.8+ via IHC?)
01/23/2007 Re-excision Lumpectomy: No clear margins on the DCIS; mastectomy recommended
03/02/2007 Bilateral mastectomy w/ expander implant insertion
03/19/2007 Emergency surgery to fix broken blood vessel in left breast
03/30/2007 Met w/ oncologist; oncologist checking on HER2 status with pathologist and doing some consulting on my case - no treatments for now!
05/02/2007 Next appointment w/ oncologist
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05-02-2007, 04:46 PM
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#2
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Senior Member
Join Date: Sep 2005
Posts: 161
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If it was me, I would get my own second opinion regarding no further treatment.
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Diag. Oct. 2004 age 54 left breast
Stage 1 grade 3; 6mm IDC; unknown amount of DCIS
with comedo necrosis; node neg.
Nottingham Grade 7/9
ER 91% PR 62%; Her2 3.6 by ICH; KI-67 35%
Nov 2004 Lumpectomy; SNB failed so had
full axillary clearance;
Dec 2004 2nd lumpy for clean DCIS margins.
Jan/Feb 2005 4 A/C dose dense;
33 rads finished 6/2005;
Began 5 years Arimidex in 6/2005
No Herceptin
9/2007 Quit Arimidex due to severe side effects.
NED
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05-04-2007, 09:33 AM
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#3
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Senior Member
Join Date: Sep 2005
Location: Alaska
Posts: 2,018
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Hello Kathy,
Just wondering what your age at dx was, and if you have had any markers done (CA 15-3 or CA 27.29) what the result was?
AlaskaAngel
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05-04-2007, 12:03 PM
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#4
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Senior Member
Join Date: Jan 2007
Posts: 72
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Hey Angel!
I was/am 46. My doc doesn't do markers.
Thanks,
Kathy
__________________
12/01/2006 Initial Dx via stereotactic biopsy - DCIS, grade 3
12/27/2006 Lumpectomy w/ SNB: 2 foci of IDC (largest .3 cm, Grade 2, Notthingham score 6) amid large area of DCIS: No clear margins on the DCIS; re-excision recommended
ER+(55%)/PR+(60+)/HER2+ (2.8+ via IHC?)
01/23/2007 Re-excision Lumpectomy: No clear margins on the DCIS; mastectomy recommended
03/02/2007 Bilateral mastectomy w/ expander implant insertion
03/19/2007 Emergency surgery to fix broken blood vessel in left breast
03/30/2007 Met w/ oncologist; oncologist checking on HER2 status with pathologist and doing some consulting on my case - no treatments for now!
05/02/2007 Next appointment w/ oncologist
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05-04-2007, 07:47 PM
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#5
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Senior Member
Join Date: Sep 2005
Location: Alaska
Posts: 2,018
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options
Kathy, I think your doc is conscientious in getting an informal second opinion from a major cancer center, but it would be worthwhile for you to be able to ask your own questions by getting a direct second opinion -- and because of being HER2, I'd want to get the opinion at a major cancer center.
I did an informal poll on another website at one point and found that around half of those with IDC also had DCIS. Yet most resources generally outline therapy in terms of having just one or the other, IDC or DCIS.
Because HR+ women at high risk for bc who have never even had bc are at least being offered the choice to consider of hormonal therapy, I think you should also be at least given that option to consider. Please do let us know how this goes for you.
A.A.
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05-05-2007, 07:35 AM
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#6
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Senior Member
Join Date: Apr 2006
Location: Wilmington, Del.
Posts: 1,126
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I also am glad your doc is consulting with Hopkins. If they suggest aggressive treatment, I hope you will seriously consider. I had a .5 cm tumor with no lymph nodes. I took the oncotype and it predicted chance of recurrence at 22.5% over 10 years. That was too high a risk for me so I took the full treatment -- chemo, radiation, herceptin and arimidex, since I'm er/pr pos. Jean's tumor was smaller than mine - about your size - and the oncotyped her risk of recurrence as higher than mine. So Her2 is a tricky, nasty little risk factor. Be cautious.
__________________
MJO
IDC, Stage I, Grade 2
Oncotype DX Score 32
Her2++ E+P+, Node Neg.
Lumpectomy 11/04/05 Clear Margins
3 Dose dense AC (Couldn't tolerate 4)
4 Dose dense Taxol & Herc. (Tolerated well)
36 weeks Herceptin (Could not complete one year due to decrease in MUGA score)
2 years of Arimidex, then three years of Femara
Finished Femara May 2011
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05-07-2007, 08:00 PM
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#7
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Member
Join Date: Feb 2007
Posts: 15
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I had a very small tumor .6cm IDC. Three med onc recommended chemo, mainly because I'm 34 yrs old. If I were 80, they would reconsider.
It was recommended that I do AC-TH or TCH or TH. I choose Taxol and Herceptin. It gives me the benefit of Herceptin with a little boost from the Taxol. It's quite manageable too. I'll do rads because I did a partial mast.
Good luck! These decisions are not easy.
__________________
Little Legos, 34 yrs old
dd 3yrs, ds 6.5yrs
12/29/06 DCIS dx grade 2-3 with necrosis and focal early microinvasion
2/7/07 Partial Mastectomy and Sentinel Node Biopsy
2/18/07 dx .6cm IDC with DCIS 1.4cm, grade 2 ER-PR-HER2+++
neg nodes (3 taken), clean margins
3/20/07 Start 12 weekly Taxol - Herceptin, more Herceptin to follow
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