Invasive Ductal Carcinoma Stage 2 - Treatment Plan?

Hi there: what was your estrogen score? Are you stage 2 or grade 2? Stage 2 because there are positive lymph nodes? Is all this info from biopsy?

Sometimes pathology is different after surgery.

If you are estrogen positive and HER2- you will probably have an Oncotype Dx and that will determine treatment.

Has a doc told you that you are having chemo? Usually the Oncotype determines that, unless you have a lot of positive nodes.

Good luck and keep us posted!

Stage 2 because of positive lymph nodes. Grade 2. Breast MRI confirmed pathology report.
I will ask about the Oncotype Dx. Thanks

I am post menopausal and had a unilateral right side mastectomy last February with 2 stage reconstruction ( saline expander inserted at time of surgery and subsequently exchanged for permanent silicone implant) completed in July.
In Jan. 2022, after a “ normal “ mammo and ultrasound in October 2021 I requested an MRI due to a persistent symptom.

BOOM! I was diagnosed with 2 foci ( 2 tumors) unilateral IDC , stage II ( 2 sentinel nodes positive - 5 above those negative) grade II, both ER/PR + HER2- .

The Oncotype indicated that chemo would NOT be beneficial in my case. I am in month 10 of an Aromatase Inhibitor… also known as “hormone therapy “ which is prescribed to limit estrogen production in post menopausal women. I will be taking this for 5-7 years. Similar estrogen limiting therapy is prescribed for pre menopausal women who need to also shut down ovarian estrogen production.

The ONCOTYPE will inform your health team regarding need for ( benefit of) receiving chemo. Since 2015 70% of women with ER/PR + HER2- breast cancer diagnosis have been spared chemo. It’s possible that a non definitive PR + may exclude the option of the ONCOTYPING ( I don’t know).

That said, I understand that if you begin hormone therapy before typing an ONCOTYPE cannot be applied to the biopsy or surgical tissue; it will have been compromised.

A new trial , TAILOR RT is now looking at the need for ( benefit of) radiation therapy. I believe it’s designed to include 1-3 node positive status. It’s still in trial and not definitive. Worth reading about.

My breast surgeons did not recommend radiation but the radiation oncologist did. That’s why I researched the benefit/risk information and found the TAILOR RT trial . My IDC profile fit that trial parameter. One arm of trial was AI alone ( hormone therapy) the other arm was AI plus standard radiation. I opted out of radiation.

Going forward I will get a yearly mammo for healthy breast alternating with a yearly MRI (for both sides ) at 6 mos. Intervals.

It’s a huge learning curve and I am sorry that you have to go through this challenging journey. For me, information is a huge plus. I hope this information has been helpful to you.

Last week I had my annual MRI the same week as my surgery last year. I am ONE YEAR CANCER FREE!

Blessings in the path. 🌸

This was so helpful. Thank you so much. Cheers to one year cancer free! I hope to say that in the coming years.

I look forward to looking back WITH YOU! 🌸

The Oncotype still applies for 1-3 positive nodes. There is a report section for those with negative nodes and a report section for those with positive nodes.
The test is for ER+, HER2- tumors. Good luck!

I’m IDC 2b
Just had a lumpectomy
Waiting for the lymph node result - they took out 9
One tumour was only found on the MRI- didn’t show on the US
Or Mamm
Waiting for the results of this the Dr. Said it
Looks cancerous
No Onoc yet i am estrogen & progesterone positive
I will
Have 4 radiation’s and the AI
Unless the treatment plan changes when I get the results
Guess I’m a lifer now

One orher tumour was cancerous and the other not

Getting the diagnosis is so overwhelming. When I found out I had a large tumor that had gone through the dermis and multiple lymph node invasion, I was frightened and just wanted someone to give me something concrete to hang onto as far as a plan of action. Unfortunately, I couldn't connect with anyone with cancer that had the same circumstances and plan as I did. I want you to know that VERY FEW people can tell you what YOUR plan will entail due to many factors. But this site has been instrumental in getting good advice, sharing different/new information, and getting hope. Hang in there.

My journey started near the end of August 2021. I knew when I had my mammogram/sonogram that I had cancer. Everything moved quickly after that as far as tests, meeting with navigator, surgeon, radiologist, and oncologist. However, my plan of action was not given to me until mid-October. This was a very hard time for me. I am a person that has a hard time waiting for answers and just wanted those answers quickly. With MRI's, PET scans, CT scan,, tumor biopsy, lymph node biopsy, waiting for Mammoprint testing of my biopsy, and tumor boards meetings, it just takes time. AND THAT IS HARD! In hindsight, I'm glad every thing was thorough and every aspect checked out.

I was hesitant and concerned about chemo, and my Mammoprint showed that chemo would only be 3% helpful. My oncologist agreed that 3% wasn't overall beneficial. My tumor was estrogen/prog. +, HER2-, 3C, with Ki-67 at 67%. In October 2022, I was put on anastroloze therapy for 6 months with hopes that my tumor would shrink. I wanted more immediate surgery, but my health care team convinced me that estrogen therapy would be best. My tumor shrank by 1/3 during that time. In May I had a lumpectomy (about 1/3 of my breast) and lymph node dissection. I had radiation M-F during June and July (38 regular and 5 boost). I had burns and no energy. My oncologist explained that the surgery would take the cancer out, but radiation worked like a vacuum removing all minute traces that might be left in the tissue, dermis, or incision site. In August 2022 I started taking Verzenio twice daily because of my high risk of reoccurrence. That was a struggle due to the diarrhea and other side effects. I am taking anastrozole daily along with Verzenio twice a day. I have been getting physical therapy to get better range of motion from the lymph node dissection and for strength. I had one breast reconstruction surgery in December and had another last week. That should be the end of my surgery.

My journey has been full of ups and downs. I have gone from being a very active person to sometimes not having energy for anything. I have experienced many side effects from both medicines. My care team has been wonderful, and I feel so fortunate to have their knowledge and support. I keep pushing myself to do more physically; I walk or do strength training daily. I have experienced some of every emotion: scared, frustrated, hopeful, depressed, angry, thankful, blessed and many more. It has been a unique journey. My advice is to have strength, question, find a care team you trust, have faith, and be positive. Good luck!

It’s true that each of our journeys are spectacularly unique. We are in this alone together but the together part has been a lifeline to me. 🌸