pathology results in chemo decision

[LizB]

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.

[tricia keegan]

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!

[Nurse4u2day]

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....

[Gail]

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.

[roz123]

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

[thinkpositive]

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.