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Breast Cancer  (Expert Forum)
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Chemo with cancer in the lymph nodes
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Cleveland - OH
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.

Chemo with cancer in the lymph nodes

by Brenda9020, Jul 09, 2008 02:43PM
Tags: chemo, family
Why would you receommend chemo if the tumor was 2 centimeters and not found in the lymph nodes (NEGATIVE).

The cancer was diagnoised as invasive ductal carcinoma, modereately diffentiated (SBR score 6;3+2+1) with lobular features.

In Situ, low grade(grade1/3)

Associated with invasive tumor(10% of tumor mass)

Estrogen receptor Positive 2-3+ 110 Favorable
Progesterone receptor Positive 3+ 90 Favorable
HER-2/Neu Negative 1+_10 Favorable

Why would you not just do radiation?  What would be the benefit of Chemo?  49 yr old.  What is there is a strong family histroty of cardio/vascular problems on both sides?

by Cleveland Clinic, Jul 10, 2008 08:48AM
Dear Brenda9020:  Whether or not to do chemotherapy depends on many factors including the size of the tumor, the histology (the way it looks under the microscope), estrogen and progesterone status, her2 neu status, etc.  Basically, the purpose of chemotherapy is to reduce the risk of recurrence and/or metastasis.  Often oncologists will estimate the risk of recurrence as well as the estimated benefit of chemotherapy and base recommendations on this.  When the tumor is hormone receptor positive (positive for estrogen and/or progesterone receptors), there is generally felt to be a benefit to endocrine therapy. Some patients will also have an additional benefit to chemotherapy. One test that has been used to try to better estimate outcome with endocrine treatment alone versus endocrine treatment plus chemotherapy is the Oncotype DX assay which is a test done on the cancerous tumor itself and looks at some of the genes expressed by the cancer. Certain profiles have been associated with more or less benefit to chemotherapy. You may want to discuss this further with your oncologist. Your oncologist would be the most appropriate person who can discuss the risks/benefits of various options with you so that you can make an informed decision.  Radiation is generally used to reduce the risk of local recurrence and is generally given after breast conserving surgery or following mastectomy for those individuals at particularly high risk for local recurrence (such as those with large tumors or significant lymph node involvement).  Radiation is not used to address prevention of recurrence anywhere else in the body as it is a local treatment only.

Member Comments (4)

by japdip, Jul 09, 2008 10:51PM
To: Brenda9020
When tumors are over 1cm, Chemo is often recommended as a part of the treatment.

by wyndi, Jul 21, 2008 06:47PM
To: brenda
I now have a 1cm or possibly two nodules that have grown very quickly over the last 4 months. I never smoked or was really around anyone much that did? I will be having a needle biopsy in 3 weeks. I pray it is something other than carcinoma. Sounds as tho you have family and doctors that are watching out for you too. I pray you come thru this tough and with a strong inner core of optimisiam.
Gwen

by lexis22, Jul 23, 2008 03:39PM
To: Brenda 9020
   I found when I was going through Radiation obviously one talks to others. It comes down to the Doctors choose. One woman had the same as me I got radiation she had both chemo and radiation, and that is the honest truth
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