So have done a lot of research- I am a patent attorney and sometimes file biotech cases so no problem reading technical papers, I read technical literature all day long at work as part of my job. Right now mostly using Google Scholar and I can access full text of most articles through a subscription I have access to. It seems (in general) chemo is quite good on agressive tumors as it attacks cells that are dividing rapidly (like your hair!). But not much on very slow tumors like mine. Read some of the original studies on Femara and, seriously, in the population being studied the risk was reduced from 6% to 3% so not sure, at 59, that it's worth it for such a small reduction. Radiation seems more promising, but still not super optimistic about that either. And, yeah, so much for mammograms...the images I looked at from my last one (the fancy 3D kind, did in March) don't even go down that far- I mean, think about where your breast is positioned and, no, it's not looking at your sternum...the guy doing my biopsy kept saying "strange" and then the mammographer would answer, "very strange" guess they didn't know I can understand a lot of Chinese.
I am dragging all my files to a private pay doctor outside the national health system for a second opinion and there are some other places that will do second opinions. Have not yet met with the pharma oncologist, 100% he will recommond AI, strongly ER positive (over 90 percent). Everyone is on the fence about chemo (surgeon, radiologist) will see what he says (and what chemo drugs) then run and do research on my own. Typically after any appointment, I go down to medical records and get whatever latest report (pathology, MRI, CD with scans) so I can read it myself. They print it out for me in English, very kind.
In general, I don't get to speak to doctors very long- while the system gets you instant appointments and biospy results to surgery was exactly 2 weeks (did all the scans in that time), the doctor sees about 100 patients in a 4-hour window (the surgeon) and other doctors I have dealt with at least 50-70 patients in a 3-hour window. But, everyone gets seen, everyone gets treated, I can't really fault their system. Not to mention the incredibly low cost (I have maybe spent 200 dollars-US- so far).
Just not a lot of literature discussing pectoral muscle invasion with tumor cells still in the margin, I guess in more tumors it's not that deep and easier to get a "clean" margin. And the one I read not that optimistic (attached here) but only a couple of data points (Johns Hopkins studies).
Thank you so much for sharing your story, gives me a little bit more optimism.
Oh, also attaching a very poor MRI image (a photo of a low-quality printout, I didn't have a CD reading, coworker printed this out for me)- this is a cross-section, it is kind of hot-dog shaped I think, running down the sternum.
@margaretb have you considered asking for a second opinion at the Mayo Clinic or other reputable cancer center? I was able to send all of my imaging and scans to them without having to be seen and was still given recommendations. The more information you have besides reading scholarly articles might help you make a decision on which path you should take regarding treatment. Best of luck to you!