Should I choose chemo

Hi rayofsunshine

I had similar diagnosis to you ER+ HER- stage 2 grade 2  high grade DCIS 2 of 3 nodes positive (macromets) and  LVI. Had mastectomy with implant reconstruction. I’m 65. I too was given choice to have chemotherapy. It was explained that although Predict only gave a 6% improvement in prognosis with the addition of chemo this correlated to over one extra person in every 20 that would avoid recurrence. 6% didn’t sound a lot but it is another life saved - and it could be mine. So I took it. I didn’t want to think the odd cell might have escaped via LVI and caused recurrence. My oncologist concurred saying Surgery gets rid of the tumor, chemo mops up any cells floating about that may have escaped then radiotherapy deals with anything that may be left locally to original site. Chemo isn’t easy, there were times I questioned my decision but I finished it in late June and radiotherapy finished last month. Now it’s behind me I’m glad I got everything thrown at this with the objective being ‘curative’ - hopefully this will give the best chance of staying disease free going forward. Obviously you have to make your own decision-it was the LVI that made it a no brainer for me. The team thought it was early stage so likely it was just the 2 lymph nodes effected but I know I would always be wondering. 
P.S have been on Letrozole for a month now and finding it ok with very mild side effects ( bit of flushing)  I think I had been more worried about this than the chemo! 

Thanks for this, it’s really helpful and glad to hear you have the treatment behind you.  It’s daunting sitting with it in front of me, but I see that it will all be over before I know it,  best of luck with your recovery now that it’s all over!

There is no doubt it’s a slog, and there will be some horrible days but it will pass and you know that you’ve done everything to give best chance of being disease free.

If you decide to go for chemo this is my experience.

I cold capped through chemo and kept enough hair to be able to go out without a head covering. I found sucking ice through chemo infusion helped me avoid mouth ulcers, drinking loads of fluid flushes drugs through and if you can exercise and get fresh air (walking or even housework/gardening) its good for mental health and recovery. Get a good thermometer and keep an eye on temperature. Stock up on Snacks! Don’t be afraid to ask for help and take all the preventative medicine offered!  I got really tired and teary towards the end….obviously a cumulative effect but it’s now 7 weeks since last chemo and I’m feeling well on the way to the new normal. Good luck with whatever you decide xx

I have a different cancer (grade 3 TNBC). It had spread to my liver via vascular invasion despite the original breast tumour being small and there being no lymph node involvement. So yes, there’s always a risk and there’s no way of knowing which way it will play for you. 

It’s a difficult decision as there are also harms from the treatment and also no guarantees on whether the treatment will be effective. Either way you have to feel you can proceed without regrets. I was advised to have chemo because my particular cancer is high risk. I went ahead with some reluctance (at this stage I didn’t know I also had a lesion in my liver) because the stats didn’t seem to make a great case for it. But I felt I would find it hard to live with myself if something subsequently happened. Of course it did, despite the chemo, but at least I knew I had done everything I could do. 

Thanks to everyone for your replies - an update from my end is that now I have suspected follicular thyroid cancer (which is not determined until I have it removed) so I think the chemo question for the breast cancer is getting pushed aside for moving forward with the thyroid.  Otherwise I would need to wait until 2025 for that surgery and I am not sure I can wait that long not knowing what is going on.  

I appreciate all the support.

I’m sorry to hear of your spread and appreciate you taking the time to respond.  Best of luck with your continued treatments.

Super helpful and appreciate the list of all the ways to prepare.  I think I am now forgoing chemo because I need a thyroid operation, and I don’t want to delay that, but appreciate you taking the time to respond.

Hi! I understand that you are in a difficult situation right now, and the choice is really not easy. The fact that you were given the opportunity to make your own decision about chemotherapy adds additional doubts.

Consider getting a second opinion from another oncologist to have more information and feel more confident in your decision. Sometimes an independent look at your situation can help you decide and reduce anxiety.

Do not forget that the purchase of all necessary drugs should be done only in trusted pharmacies to avoid health risks. Take care of yourself!