Invasive Ductal Carcinoma Stage 2 - Treatment Plan?

Posted by journey99 @journey99, Feb 18, 2023

I am newly diagnosed with IDC Stage 2, 1.3 cm in size. Estrogen Receptor positive, Progesterone positive (1-10%) so not positive enough I have been told, HER2 negative. Ki-67 15%.
I meet with the oncologist, surgeon & radiologist next week. Looking for anyone that has had a similar diagnosis that would share what they had for a treatment plan. Surgery then chemo? Chemo than surgery has been mentioned. What questions I should ask the team? What are things I should consider? Any advice is helpful. I am being told radiation is for sure since lymph nodes are involved. Thank you in advance for sharing experiences and information.

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I was diagnosed with IDC January with Estrogen + HERS- 1.8 stage 1 then MRI showed other spots within breast. I had a double mastectomy with no lymph node involvement. My oncologist sent cancer tissue for testing retuning I had to have chemo. I’ll start that end of March with Taxotere and Cytoxan chrmo meds for 4 treatments in a 12 week period.

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I was diagnosed with IDC HR+HER- stage 2B with one lymph node involvement Feb 22. I have had CT scan and bone scan and so far no other metastasis. Oncotype test was sent off and results should be in coming in two weeks. Waiting now for an MRI.

One dr suggested surgery unilateral mastectomy then radiation and chemo depending on results of Oncotype.

Another dr is waiting for results of MRI and mentioned maybe chemo then surgery then radiation.

I’m in a hold pattern and the waiting is making me crazy.

Pushing for a double mastectomy with reconstruction so I don’t have to worry spend the rest of my life in fear which I probably will be anyways.

Curious to hear about everyone’s experience.

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I was diagnosed with IDC HR+HER- stage 2B with one lymph node involvement Feb 22. I have had CT scan and bone scan and so far no other metastasis. Oncotype test was sent off and results should be in coming in two weeks. Waiting now for an MRI.

One dr suggested surgery unilateral mastectomy then radiation and chemo depending on results of Oncotype.

Another dr is waiting for results of MRI and mentioned maybe chemo then surgery then radiation. MRI is scheduled for April 4.

How do you grabble with different opinions? Who is right?

I’m in a hold pattern and the waiting is making me crazy.

Pushing for a double mastectomy with reconstruction so I don’t have to worry spend the rest of my life in fear which I probably will be anyways. Should I be pushing for a double? I’m so torn.

Curious to hear about everyone’s experience. Thank you for sharing.

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I had stage 1a no metastasis but if I did I would get both breasts done. Your life is not a gamble. Just my thoughts. Hang in there and get therapy support. Prayers to you

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@lesleyjt

I was diagnosed with IDC HR+HER- stage 2B with one lymph node involvement Feb 22. I have had CT scan and bone scan and so far no other metastasis. Oncotype test was sent off and results should be in coming in two weeks. Waiting now for an MRI.

One dr suggested surgery unilateral mastectomy then radiation and chemo depending on results of Oncotype.

Another dr is waiting for results of MRI and mentioned maybe chemo then surgery then radiation.

I’m in a hold pattern and the waiting is making me crazy.

Pushing for a double mastectomy with reconstruction so I don’t have to worry spend the rest of my life in fear which I probably will be anyways.

Curious to hear about everyone’s experience.

Jump to this post

Lumpectomy and lymph node surgery next week. I have authorized unilateral mastectomy if surgeon and pathologist determine it is necessary once the tissue is being tested during surgery. I have been taking Letrozole for 3 weeks, with the hopes that they would test my Ki 67 from surgery and if it changed and indicated my body was responding to the medication then probably radiation and no chemo. The concern was over treating since my Ki67 is borderline. Plan changed with Oncotype results. Surgery is still next week however Oncotype came back at 30 so now I will do chemo. I have decided to go ahead with surgery first because the chemo plan is different depending on the number of lymph nodes involved.

I agree the waiting is the worst. Wishing you the best.

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@lesleyjt

I was diagnosed with IDC HR+HER- stage 2B with one lymph node involvement Feb 22. I have had CT scan and bone scan and so far no other metastasis. Oncotype test was sent off and results should be in coming in two weeks. Waiting now for an MRI.

One dr suggested surgery unilateral mastectomy then radiation and chemo depending on results of Oncotype.

Another dr is waiting for results of MRI and mentioned maybe chemo then surgery then radiation.

I’m in a hold pattern and the waiting is making me crazy.

Pushing for a double mastectomy with reconstruction so I don’t have to worry spend the rest of my life in fear which I probably will be anyways.

Curious to hear about everyone’s experience.

Jump to this post

I had IDC 2B one tumour in each breast. A MRI picked up one rhat the Mamm & U/S didn’t.
All 2 Dr recommended skin saving lumpectomy
I wanted a mastectomy
Lost bld supply in one breast & nipple
Necroses with post op infection IV & 3 oral antibiotics and packing
Now the surgeon says a mastectomy would be good!
Lymph nodes ~ve
Waiting for oncotype & genetic testing results
I will be getting g 5 radiation & start on the estrogen inhibitor & Zometa
With FU US MMm & MRI
I cried for months
But now thankful & living for today not redundant yesterdays & uselss projections in the future

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@lesleyjt

I was diagnosed with IDC HR+HER- stage 2B with one lymph node involvement Feb 22. I have had CT scan and bone scan and so far no other metastasis. Oncotype test was sent off and results should be in coming in two weeks. Waiting now for an MRI.

One dr suggested surgery unilateral mastectomy then radiation and chemo depending on results of Oncotype.

Another dr is waiting for results of MRI and mentioned maybe chemo then surgery then radiation.

I’m in a hold pattern and the waiting is making me crazy.

Pushing for a double mastectomy with reconstruction so I don’t have to worry spend the rest of my life in fear which I probably will be anyways.

Curious to hear about everyone’s experience.

Jump to this post

I am so sorry to hear your diagnosis. Waiting to learn a specific plan was probably the hardest part for me. It took my care team about eight weeks from my diagnosis to the time I got my plan. That time was horrible; I couldn't sleep, I did research on every aspect that could be applicable, and I was so scared. I had two MRIs, CT scan, tumor biopsy, lymph node biopsy, waited for my oncotype test, other tests, and multiple tumor boards. I did not realize that so many tests were needed and so many things taken into consideration. It is a process.

My oncotype testing was very helpful. It showed that chemo would only be 3% beneficial and my oncologist agreed that with everything involved in chemo, that this was not worth the benefit. I had a large tumor in my right breast that had spread to at least three lymph nodes. IDC HR+ HER2 - stage 3C. I took anastrozole for six months in the hopes of shrinking the tumor/lymph nodes in order to make it more manageable. It seemed like just more waiting when I wanted action, but it did shrink everything by 1/3. I had a partial mastectomy and lymph node dissection in May and had radiation M-F in June and July (38 regular and 5 boosts). Because of my lymph node involvement and high KEY 67 score, I started taking Venzenio with my anastrozole in August. In have monthly blood tests and checks my my oncologist. It has been a journey and one that I will be on forever. I will never be able to control my cancer, but I finally feel I have some control of my future.

I wanted to have plastic surgery for reconstruction during my tumor surgery. With the radiation needed because of the lymph nodes, I was told that was not ideal. Radiation changes tissue and skin cells and the chances that both breasts would be symmetrical after radiation to only one would be a problem. So I did not do reconstruction during the surgery. I have had two reconstruction surgeries since and am happy with the results.

I guess what I want you to know is that I understand your need for some answers. I was the same way. I did not ever connect to anyone that had the same journey I had, so even though I got a lot of good advice from this group, NO ONE can tell you what your plan will be. So much depends on testing results, your oncotype results, your care team, and decisions you will need to make. I also planned on a double mastectomy with reconstruction just so I wouldn't have to worry in the future, but my surgeon convinced me that this was not necessary. Everything I thought I would do initially changed after I was actually on my journey. Going through the process is actually easier that worrying initially what might be and what you might do. I'm praying that you get your plan soon and can start the process. The initial waiting to get a plan was probably the hardest part of this for me. Good luck and praying for good results.

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@kammcn

I am so sorry to hear your diagnosis. Waiting to learn a specific plan was probably the hardest part for me. It took my care team about eight weeks from my diagnosis to the time I got my plan. That time was horrible; I couldn't sleep, I did research on every aspect that could be applicable, and I was so scared. I had two MRIs, CT scan, tumor biopsy, lymph node biopsy, waited for my oncotype test, other tests, and multiple tumor boards. I did not realize that so many tests were needed and so many things taken into consideration. It is a process.

My oncotype testing was very helpful. It showed that chemo would only be 3% beneficial and my oncologist agreed that with everything involved in chemo, that this was not worth the benefit. I had a large tumor in my right breast that had spread to at least three lymph nodes. IDC HR+ HER2 - stage 3C. I took anastrozole for six months in the hopes of shrinking the tumor/lymph nodes in order to make it more manageable. It seemed like just more waiting when I wanted action, but it did shrink everything by 1/3. I had a partial mastectomy and lymph node dissection in May and had radiation M-F in June and July (38 regular and 5 boosts). Because of my lymph node involvement and high KEY 67 score, I started taking Venzenio with my anastrozole in August. In have monthly blood tests and checks my my oncologist. It has been a journey and one that I will be on forever. I will never be able to control my cancer, but I finally feel I have some control of my future.

I wanted to have plastic surgery for reconstruction during my tumor surgery. With the radiation needed because of the lymph nodes, I was told that was not ideal. Radiation changes tissue and skin cells and the chances that both breasts would be symmetrical after radiation to only one would be a problem. So I did not do reconstruction during the surgery. I have had two reconstruction surgeries since and am happy with the results.

I guess what I want you to know is that I understand your need for some answers. I was the same way. I did not ever connect to anyone that had the same journey I had, so even though I got a lot of good advice from this group, NO ONE can tell you what your plan will be. So much depends on testing results, your oncotype results, your care team, and decisions you will need to make. I also planned on a double mastectomy with reconstruction just so I wouldn't have to worry in the future, but my surgeon convinced me that this was not necessary. Everything I thought I would do initially changed after I was actually on my journey. Going through the process is actually easier that worrying initially what might be and what you might do. I'm praying that you get your plan soon and can start the process. The initial waiting to get a plan was probably the hardest part of this for me. Good luck and praying for good results.

Jump to this post

Thank you so much for sharing your journey. I really appreciate it.

REPLY
@kammcn

I am so sorry to hear your diagnosis. Waiting to learn a specific plan was probably the hardest part for me. It took my care team about eight weeks from my diagnosis to the time I got my plan. That time was horrible; I couldn't sleep, I did research on every aspect that could be applicable, and I was so scared. I had two MRIs, CT scan, tumor biopsy, lymph node biopsy, waited for my oncotype test, other tests, and multiple tumor boards. I did not realize that so many tests were needed and so many things taken into consideration. It is a process.

My oncotype testing was very helpful. It showed that chemo would only be 3% beneficial and my oncologist agreed that with everything involved in chemo, that this was not worth the benefit. I had a large tumor in my right breast that had spread to at least three lymph nodes. IDC HR+ HER2 - stage 3C. I took anastrozole for six months in the hopes of shrinking the tumor/lymph nodes in order to make it more manageable. It seemed like just more waiting when I wanted action, but it did shrink everything by 1/3. I had a partial mastectomy and lymph node dissection in May and had radiation M-F in June and July (38 regular and 5 boosts). Because of my lymph node involvement and high KEY 67 score, I started taking Venzenio with my anastrozole in August. In have monthly blood tests and checks my my oncologist. It has been a journey and one that I will be on forever. I will never be able to control my cancer, but I finally feel I have some control of my future.

I wanted to have plastic surgery for reconstruction during my tumor surgery. With the radiation needed because of the lymph nodes, I was told that was not ideal. Radiation changes tissue and skin cells and the chances that both breasts would be symmetrical after radiation to only one would be a problem. So I did not do reconstruction during the surgery. I have had two reconstruction surgeries since and am happy with the results.

I guess what I want you to know is that I understand your need for some answers. I was the same way. I did not ever connect to anyone that had the same journey I had, so even though I got a lot of good advice from this group, NO ONE can tell you what your plan will be. So much depends on testing results, your oncotype results, your care team, and decisions you will need to make. I also planned on a double mastectomy with reconstruction just so I wouldn't have to worry in the future, but my surgeon convinced me that this was not necessary. Everything I thought I would do initially changed after I was actually on my journey. Going through the process is actually easier that worrying initially what might be and what you might do. I'm praying that you get your plan soon and can start the process. The initial waiting to get a plan was probably the hardest part of this for me. Good luck and praying for good results.

Jump to this post

I agree that each journey is quite unique. Interesting that Anastrozole shrunk the diseased areas by 1/3! I’m then assuming that the ONCOTYPE was done on biopsy tissue vs. surgically removed tissue.

I also had Er+ 99%, HER2- , 2 node + with favorable ONCOTYPE. I had a unilateral mastectomy. Opted out of radiation ( breast surgeons did not recommend) and based on information gleaned from many many hours of research on the pros and cons… including the final piece; a clinical trial TAILOR RT. This trial which is to radiation what chemo was to TAILOR DX ( which established the ONCOTYPE and benefit OR NOT for chemo) . From a BC profile I fit the trial… one arm of which was aromatase inhibitor only and other arm was AI plus standard radiation. At phase 3 they pretty much understood that AI alone was not a inferior treatment option.

A question still lingers for me however … as KI-67 was 22… just over low border. Verzenio has come up. What was your KI 67 and how are you managing on the Verzenio?

Blessings on the path 🌸

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@journey99

Lumpectomy and lymph node surgery next week. I have authorized unilateral mastectomy if surgeon and pathologist determine it is necessary once the tissue is being tested during surgery. I have been taking Letrozole for 3 weeks, with the hopes that they would test my Ki 67 from surgery and if it changed and indicated my body was responding to the medication then probably radiation and no chemo. The concern was over treating since my Ki67 is borderline. Plan changed with Oncotype results. Surgery is still next week however Oncotype came back at 30 so now I will do chemo. I have decided to go ahead with surgery first because the chemo plan is different depending on the number of lymph nodes involved.

I agree the waiting is the worst. Wishing you the best.

Jump to this post

The waiting will be soon be over for you. I felt so much better to have exhausted my research (and my near paralyzing trauma if a BC diagnosis) and moved on to surgery and subsequent treatment. Unilateral mastectomy with beginning reconstruction, February 22… now one year out, 11 months on Anastrozole and doing well. MRI clear at one year.

PS: neither Mammo nor US picked up my tumors -2 in one breast.

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