Trying to figure out whether chemo benefit outweighs SE's. I'm 43, triple negative, BRCA2+. IDC was completely taken out with stereotactic biopsy needle and 2nd opinion finds it to be .3 cm. Bilat MX found only .9 x .8 DCIS remaining, and 2nd opinion said there was the tiniest bit of microinvasion present, almost non existent. No lymphatic/vascular invasion, 0/3 nodes. I was recommended having 4 rounds TC by 1st oncologist who didn't know the size of IDC. Second onc is agreeing with that plan, agreeing it's somewhat of a gray area. He said DFS with no chemo would be about 80%, and taking chemo would make is about 89%, but that was according to Adjuvant! Online. Are there any studies on such small tumors to indicate what is best for me? What is your general opinion?
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Q: Chemo or No Chemo for 3 mm Triple Negative IDC?
Hi - I'd say to ask your doctor about possible studies covering your diagnosis. Or Google your symptoms, and see if anything comes up. It's a tough decision; since chemo is the only defense against triple-negative recurrence, it's usually a given. However, with the small size of the tumor and the apparently early stage of your cancer, plus no nodal involvement, it's hard to feel good about chemo, especailly since th side effects can be pretty daunting - expecially with a taxane drug, which can produce long-lasting (or even permanent) neuropathy.
You might consider getting a second opinion at a Comprehensive Cancer Center, if you haven't already done so. These large centers have the benefit of having dealt with many more cancer patients, and thus they have more data on outcomes to draw from. Good luck - PJH
To get a sense of what those numbers mean, picture your self in a room with nine other women with the same diagnosis. The doctor says, "If none of you get chemo, two of you will have a recurrence. If all of you get chemo, only one of you will have a recurrence."
The chemo is unnecessary treatment for eight women, but it saves the life of the ninth. What you do in a situation like this depends a lot on your personality and tolerance for risk. No doctor is going to want to give advice that would lead to a ten percent unnecessary death rate, especially when you consider that doctors might see hundreds of women with a diagnosis similar to yours in a year. However, chemo has its own set of risks, so eventually it comes down to what scares you most: the possibility of recurrence or the problems with chemo. Good luck in making your decision. Once you make it don't second guess yourself.
This compilation of links to articles about chemo will give you lots of tips. Write back as you have more questions. Since most of the stats your doctor gave you are probably for five years, your young age is another reason to lean towards chemo. I wish you the best as you make your decisions.
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Thank you both for your opinions. Being that I'm 43, triple neg, BRCA2+ AND have a 3 yr old son depending on me, I will most likely do the chemo. Chemo scares me, but cancer scares me more and if I didn't take it and had a recurrence, I'd never be able to forgive myself. The majority of people survive the chemo with little, if any, long term SE's. Going through it isn't fun, but "doable" (a term I'm beginning to understand). If anyone else has suggestions on supplements or tips that help during chemo, please let me know.