Undecided as to which treatment path to follow!

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Hi, I am new to this community and am hoping you might help me reach a decision! I have stage 3 breast cancer. I’ve undergone a mastectomy to remove the tumour. Cancer was found in the sentinel node so I then had axillary clearance. Only 6 nodes were removed and thankfully they were negative. As my cancer is low Oestrogen (ER3), Progesterone negative and HER 2 negative, I am in a ‘grey area’  for follow-up treatment. I have been offered chemotherapy but most literature I read indicates that the benefits are not proportionately much higher than having no chemo. The alternative would be radiotherapy to target just the chest wall possibly followed by endocrine treatment (Letrozole) and targeted treatment (Abemaciclib) for up to 2 years. I am thinking I’ll have Radiotherapy although am a bit concerned about getting lymphodema as I have it in my left arm from previous breast cancer on the other side. My present cancer is not very responsive to Letrozole or Abemaciclib either. Please, has anyone on this forum had this dilemma and what decision did you reach? 

  • I’m not sure if this is helpful but have you been offered an oncotype test?? This might be useful in working out if chemotherapy is worth considering perhaps??

    I wish you all the luck - there will be a right solution out there for you. I hope someone on here can help 

  • Thank you for getting in touch. My oncologist said that normally they would do an oncotype test but in my case because my ER status was 3 and with my previous history of breast cancer the MDT decided to discuss upfront chemotherapy. I guess it may help my decision if I had the test and so I’ll ask about it on Monday.  Thank you. 

  • It might be worth asking if they believe the outcome of oncotype would = chemo.  I paid for a prosigna test and looking at the example results indicated my outcome.  My score was a little different but fortunately chemo wasn’t required.

    ki67 is one indicator from memory.  There are lots I think.  

    as to benefits of chemo, remember predict relates to life expectancy, now showing up to 15. Years, there is a new version.

    but remember there is also risk of recurrence, a Dutch study recently shared results, so worth a read.  

  • Thank you, this is helpful. I’d not heard of the Prosigna test but have now looked it up and will ask my Breast Care Nurse about it. 

  • Hi I’m currently in the position of having to decide too. I have had an oncotype test but in my mind the benefits of chemo seem a small percentage. I appreciate it’s a very individual choice but I’m really struggling to decide too. Either choice is not one I want to be making. Im sorry it’s not a more helpful response but I do understand your situation and hope you can come to a decision.