NCCN Guidelines and adjuvant therapy

[jjames]

Post double masectomy i am getting oncologists opinions for adjuvant therapy since my original diagnosis of dcis at biopsy changed at surgery; the pathology report from surgery revealed a small 6mm tumor stage 1a grade 3 invasive bc Her2/neu positive and very weak positive for ER PR, so weak that one oncologist considered it negative when he ran the NCCN guidelines.

anyway, i seem to fall inbetween the No Adjuvant therapy and "consider adjuvant chemo therapy with trastuzumab", basically TCH. One oncologist says since the size is 6mm it is very small and not worth the harsh treatment to put my body through. Another oncologist said because of the aggressiveness of the her2 and the grade 3 tumor and my young age (45) she highly recommends adjuvent therapy.

I dont know what to do. the footnotes on the Guidelines seems to say they cant statistically prove benefit, but cant prove that it doesnt benefit and that there are risks in therapy that need to be wieghed against the unknown benefits.

One oncologist said i have up to a 25% of it recurring, but i cant find that information anywhere in any study. If i truly beleived the chances were that high i would go on the therapy.

Has anyone else had to make the decision on their own because they fell within the range where they cant prove benefits but can't unprove it either?

I'm totally lost right now.