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Chemo or not

Breast Cancer | Last Active: Nov 25, 2022 | Replies (14)

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@windyshores

What is the actual ER score?

For hormonal cancers, we all have an increase in risk over the years, past 5 years.

Risk and benefit from chemo may be independent of each other.

I would
1) request an Oncotype as well. In my experience tests can vary in results but it would be reassuring to get a similar risk level. You will have to locate and ship post-surgical specimens. I actually got involved in choosing which block to try to get the highest risk area sent to the Oncotype lab.
2) get however many opinions you need to feel sure (I got 4!). Consider seeing an oncologist who specializes in lobular, like Oscar Metzger https://www.dana-farber.org/find-a-doctor/otto-metzger/ He has some videos online about lobular. One example of specific concerns with lobular: lobular is always tubular. how does that make the grade look worse than it is?
3)Is tamoxifen a possibility?

Again the key question is not necessarily risk but whether chemo is of benefit (and how much benefit from hormonal treatment). I say that as something to explore, not something I have definitive info on (especially for a younger person). But the common idea that a cancer is "worse" if chemo is given is not necessarily true. I know women with one positive node who did not do chemo. Get more opinions!

Lobular is different from ductal and there is some advocacy going on for that subset. https://lobularbreastcancer.org/ Get in touch with those who are expert in this area.

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ps Lobular is harder to find in imaging. Did they do an MRI or ultrasound of the entire breast as well as the other breast?