Oncology, does that mean definite chemotherapy?

Hi all

I have stage 2 grade 2 breast cancer with a positive node. I have had a lumpectomy and cavity shave and was told yesterday they have achieved clear margins, thank goodness! I was led to believe that my next steps would be radiotherapy and tamoxifen (I'm 47) but I was told yesterday that the outcome of the MDT was that I should have an appointment with an oncologist to discuss.

I was previously a bit surprised that I wouldn't have chemo given the node involvement but despite that I was still a bit shocked when it suddenly became a possibility. However, the nurse said she couldn't tell me anything further about the MDT discussion as I need to speak to the oncologist.

So now I am waiting for an appointment (always waiting!) and still feeling completely uncertain about what the next steps are. I know if I am given a choice I will take chemo - psychologically I think the 'chuck everything at it' approach will give me greater peace of mind, but I can't help feeling like I'd rather just be told whether I NEED it or not. Such a complete mishmash of contradictory emotions :( 

My mother died of BC at 38 having been diagnosed at 29 (I was 8 when she died) so I suspect it may be my family history that is raising question marks about my treatment plan. 

I was just wondering what choices other people have made and if they are happy with their decision?

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  • Hi SharLou,

    A very warm welcome to our forum.

    I am so sorry to hear that you lost your mum at such a young age. I also lost my mum to secondary breast cancer. Unfortunately, a cancer diagnosis brings many stages of uncertainty and these all tend to play with our minds. Most decisions about the optimum treatment for you, will be made at the MDT meeting. This is where all of the people involved in your care, decide between them, how to proceed with your care. This can only be decided when they have the results of your initial scans. biopsies, etc, so nothing can be decided upon, until they have these back. This makes your treatment a team decision, rather than an individual one. This is reassuring, as there is less likelihood of any mistakes being made.

    I had 2 bouts of breast cancer 14 years ago and saw an oncologist, who recommended that I had radiotherapy. For reasons, which I won't go into, there had been a delay of 11 months before I saw her and I didn't feel sure that this would work, so long after surgery. I was sent to see two eminent researchers in radiotherapy. One thought that I might as well try it, but the other was insistent that it would not be effective if administered so long after my operation. He seemed by far the more knowledgeable and could back up his opinion well, so I took his advice. Instead I took Tamoxifen for the first year and changed to Letrozole, when I discovered a second cancer in the same breast the following year. I took this for 6 and a half years (Both of my cancers were Pure Mucinous, stage 1, with no lymph node involvement)..

    Given your family history, the fact that your cancer is stage 2 and that you have a positive node, you may possibly  be advised to have chemo, as "a belt and braces approach". If I were in your position, I would feel like you and want to "throw everything at it", but you'll be able to discuss the benefits with your oncologist before making a final decision. There is a test that can be done to determine how beneficial chemo might be for you and it would be worth discussing this with your oncologist, before making the final decision.

    I hope that you get your appointment through soon and that, between the two of you, you reach the best decision.

    Please keep in touch and let us know how you get on. We are always here for you.

    Kind regards,

    Jolamine xx

  • Thank you so much everyone for your replies. I saw the oncologist on Tuesday and it was recommended that I have a course of chemotherapy, so I will start treatment on 5 September. Bit shocked but if it is needed so be it. 

    Thanks again for your responses, it is such a help being able to talk to people who 'get' it xx

  • Hi SharLou, I am also starting chemo on the 5th Sept...hope all goes well xx

  • You too Hayley! I'm getting a bit more nervous now  xx

  • Me too!! I have a pre-assessment on Monday 2nd, so am trying to think of the questions I need to ask!xx

  • ...I am 48,& have had surgery to remove a 30mm 'invasive mixed ductal &lobular carcinoma' grade 2.  They took a biopsy of the node-it came back with 'extracapsular extension', that's why they have recommended 6 cycles of chemo xx

  • Oh our stories are quite similar! I don't know what extracapsular extension means but I guess it means it's ventured into the node? I was so shocked that there was node involvement, I just wasn't expecting it. My education appointment is on Wednesday, picc line on Tuesday. If you think of any good questions let me know - I feel like I don't know enough to know what to ask! Xx

  • I think it means that it's started to progress outside of the node capsule!!! They told me it would probably be radiotherapy, but because of the node they said preventitive chemo would help stop it coming back due to my 'young' age

    I know, I sometimes feel like I don't know really what's going on...I go to these appointments& just say that if that's what they recommend, then I'll go with it.

    Our stories sound very similar, so I will keep in touch. I will let you know how my Monday assessment goes(I don't even know if I'm having a picc line yet!!)&any questions I think of! Take care xx

  • Yes do stay in touch! I'll keep you updated with anything I find out too. I think I've taken the same approach as you too - if they say I need it, I just say OK! In fact when they first told me I had cancer I just sat and said OK thank you. They must have thought I was a bit bonkers Xx

  • Ha...yes, that's how I was as well. I didn't really know the right thing to say!!

    One of my main worries is that I am feeling perfectly fine at the moment, and chemo is going to make me feel rotten(even tho I know it'll be doing me good in the long run!!)

    I'll be in touch soon xx

  • Hi SharLou, just to let you know that I had my pre-assessment yesterday...I was there just under 90mins-watched a short video, had blood test&ECG. She went over everything so I couldn't think of any questions to ask. In on Thursday at 11.30 for 1st chemo...only going to take 30mins to administer it(I thought I was going to be there for hours!!!) xx

  • Ah that's good news that they were so thorough with the details! I've got my education appointment tomorrow, first treatment on Thursday at 9.30am. I had my picc line fitted today, quite a bizarre experience but not painful or anything. 

    Definitely getting real now isn't it!!! Xx

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  • Ah that's good news that they were so thorough with the details! I've got my education appointment tomorrow, first treatment on Thursday at 9.30am. I had my picc line fitted today, quite a bizarre experience but not painful or anything. 

    Definitely getting real now isn't it!!! Xx

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