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One other suggestion is for you or your cousin to access Adjuvant Online. This database is used by a very large number of oncologists to give their patients the statistical probabilities of recurrence and mortality and to show by what percentage recurrence is reduced through chemotherapy. I did chemotherapy, even despite Adjuvant showing that I reduced risk by only 7/10 of one percent. I am still not sure if I made the right decision as I do, indeed, have chemo brain and neuropathy. I should also note that Adjuvant at this time does not include HER2 positive as a risk factor (coming soon) but it does include ER negative, which to an extent takes into account the HER2 reading. Please note that when you access Adjuvant it states that it is only for medical personnel, but you can still get in and use it, and get the same results as your doctors.
Regarding older versus younger: There are differences in the way cells grow in those who are older--i.e., more slowly as we age. So the hypothesis is that cancer cells replicate more slowly. And the elderly are also more susceptible to certain chemo side effects (perhaps because healthy cells also don't replicate as easily when we're older), which may be why oncologists are less likely to recommend chemo to older patients. Also if a person has good risk factors with respect to the breast cancer and is in her mid-sixties or mid-seventies, an oncologist might feel that the risks of chemo outweigh its benefits. I don't believe, though, that the age cutoff is 50 for rethinking chemo. i beleive it begins at 65.
It probably makes sense for each woman to do her own research (with the benefit of sites like this) and based on her findings discuss the risks and benefits (and her fears) with an oncologist she trusts. It's also good to make the decision together with family, since everyone in a family dealing with cancer is involved. Again, good luck.
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