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This question was answered on Wed 04, Jun 2008 04:47am by Dr Paul S, MD

Treatment options ER/PR negative Stage II IDC in breast


    
Asked by gs60 (Female; 59; IDC in R breast diagnosed April 2008; MBR grade II/III (tubule formation 2, nuclear grade 3, mitosis 1); 0.7 cm; lumpectomy May 20, clear margins (smallest 0.6 cm), sentinel node negative; ER/PR negative ) on Tue 03, Jun 2008 08:48am

I am 59 years old, otherwise in excellent health. With this recent breast cancer (see medical history), I am now waiting for an appointment with an oncologist (expected 4-6 weeks from now). What are the likely treatment options? I know I will have radiation, likely not a hormone blocker, but what about chemo? Is there any indication this will help? (There is no cancer of any type in my family till now). Thank you.
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Answer by Dr Paul S, MD  on Wed 04, Jun 2008 04:47am:

Hi there. The National Cancer Care Network (NCCN) breast cancer guidelines tell us that tumors that are between 0.6-1.0 cm in size may be offered chemotherapy, though the clinical benefit from such treatment may not be that pronounced. I believe that the benefit that you can derive from additional chemotherapy will be about less than 5% in terms of decreasing the chance of recurrence. The decision to give chemotherapy for tumors this small may also be influenced by the tumor grade, and if the tumor will be determined to have the Her2/Neu amplification. The benefit from chemotherapy in your situation may be outweighed or just marginally canceled by the risks of side effects of the chemotherapy. This option should be well discussed with your oncologist by the time you get to meet. All in all, I believe that you have a very favorable disease and I congratulate you and your doctors for having detected this early. I suggest you discuss with your doctors regarding additional Her2 testing to aid in the decision making. Regards and God bless.

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