Most Women In The Mid
The new study looked at the 6,711 women from the trial who fell in the mid-range of 11 to 25. The goal of the study was to find out if these women could safely skip the chemotherapy.
Following surgery, the women were randomly assigned to receive chemotherapy followed by hormone therapy, or hormone therapy alone. The study was intended to measure invasive disease-free survival, the proportion of women who had not died, or had their cancer return, or developed a new cancer. Results were very similar between the 2 groups.
- Five years after treatment, the rate of invasive disease-free survival was 93.1% for those who had chemo and 92.8% for those who did not.
- Nine years after treatment, the rate of invasive disease-free survival was 84.3% for those who had chemo and 83.3% for those who did not.
Rates of overall survival were also very similar between the 2 groups.
- Five years after treatment, the rate of overall survival was 98.1% for those who had chemo and 98.0% for those who did not.
- Nine years after treatment, the rate of overall survival was 93.8% for those who had chemo and 93.9% for those who did not.
Personal Stories About Choosing Chemotherapy For Breast Cancer
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I was diagnosed with breast cancer 3 years ago. It was quite a shock. Even though my breast cancer was small and I did not have any cancer cells in my lymph nodes, I decided to take chemotherapy. My doctor said that even though it would not guarantee that the cancer would not come back, it would improve my chances for a cure. I was really worried about the side effects, but they were not that bad. I just wanted to do everything in my power to beat this breast cancer. My checkups have been fine so far, so I think I made the right choice.
Laurel, age 43
I was diagnosed with breast cancer about 3 years after I went through menopause. My breast cancer was small, and I did not have any cancer in my lymph nodes. I stopped taking my menopause hormones, had surgery and radiation, and have been taking tamoxifen ever since. I see my doctor a couple of times a year and so far have been okay. I’m going to ask my doctor if I’m a good candidate for switching to something like Arimidex. I hear that it’s a smart choice for some women.
Brenda, age 57
Paula, age 61
Reasons To Wait A Short While
While information suggests having surgery within a few weeks and chemotherapy within a month is ideal, there are some very good reasons why you may wish to wait a few days or a few weeks to begin treatment.
Most surgeons and oncologists will reassure you that you have some time, though there are always exceptions to that general rule . Advantages of taking some time include:
Breast Cancer Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
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What Is The Cost Of The Test
Oncotype DX costs about $4,000 but, according to Genomic Health, 90% of insured Americans carry an insurance policy that will cover the testing.
If your insurance does not cover this specific test, Dr. Gormans office will help you contact your insurance company to try to receive more financial assistance. Insurance companies may choose to help cover the test since the cost of Chemo and radiation are more expensive.
Who Is A Good Candidate For Neoadjuvant Therapy
Patients should meet a few requirements to be a candidate for neoadjuvant therapy. The size of the tumor, the type of breast cancer they have, and whether lymph nodes are involved are all things a doctor will consider before suggesting this form of treatment. Some forms of breast cancer are more likely to respond well to neoadjuvant therapy.
Unless a tumor is small and there is no lymph node involvement, most patients who have eitherHER2-positive breast cancer or triple-negative are good candidates for using chemotherapy either before or after their mastectomy.
With the best outcomes, this therapy can eliminate all visible tumors from the breast and produce what is known as a pathologic complete response to the treatment. That means the doctor will find no trace of the invasive tumor in the breast or the lymph nodes after the patient has received treatment.
Women who have estrogen receptor-positive breast cancer, which is the most common type, may not be good candidates for neoadjuvant therapy. Instead, these patients may benefit from anti-estrogen treatment to help shrink their tumor before surgery.
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Mouth Sores Are A Problem For Many People Are There Foods That Are Easier On A Sore Mouth
The following tips can help you cope with chemotherapy-associated mouth sores:
- If you have been prescribed a mouth rinse to treat pain, time its use so that you can eat when your mouth is less sensitive.
- Eat your foods at room temperature or cooler.
- Avoid very hot and very cold foods.
- Avoid citrus, spicy, and strong minty flavors.
- Avoid dry and sharp foods such as toast, crackers, and chips.
- Suck on ice chips, popsicles, or frozen fruit. Some chemotherapy medications cause cold intolerance, so avoid this if you have been told to skip very cold foods.
- Avoid fruit and vegetables with small seeds.
- Do not use alcohol or tobacco.
- Avoid acidic foods and beverages such as lemons, limes, tomato sauce, oranges, and orange juice.
- Try moist, bland foods such as oatmeal, pudding, and custards.
- Avoid fizzy and carbonated beverages.
- Do not use commercial mouthwashes that contain alcohol.
- Ask your nurse if there are recommended toothpastes and other products for people with mouth sores.
If you are unable to eat due to mouth sores, tell your doctor know right away.
Starting With Neoadjuvant Therapy
Most often, these cancers are treated with neoadjuvant chemotherapy . For HER2-positive tumors, the targeted drug trastuzumab is given as well, sometimes along with pertuzumab . This may shrink the tumor enough for a woman to have breast-conserving surgery . If the tumor doesnt shrink enough, a mastectomy is done. Nearby lymph nodes will also need to be checked. A sentinel lymph node biopsy is often not an option for stage III cancers, so an axillary lymph node dissection is usually done.
Often, radiation therapy is needed after surgery. If breast reconstruction is done, it is usually delayed until after radiation is complete. In some cases, additional chemo is given after surgery as well.
After surgery, some women with HER2-positive cancers will be treated with trastuzumab for up to a year. Many women with HER2-positive cancers will be treated first with trastuzumab followed by surgery and then more trastuzumab for up to a year. If after neoadjuvant therapy, any residual cancer is found at the time of surgery, trastuzumab may be changed to a different drug, called ado-trastuzumab emtansine, which is given every 3 weeks for 14 doses. For people with hormone receptor-positive cancer in the lymph nodes who have completed a year of trastuzumab, the doctor might also recommend additional treatment with an oral drug called neratinib for a year.
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Menstrual Changes And Fertility Issues
For younger women, changes in menstrual periods are a common side effect of chemo. Premature menopause and infertility may occur and may be permanent. Some chemo drugs are more likely to cause this than others. The older a woman is when she gets chemotherapy, the more likely it is that she will go through menopause or become infertile as a result. When this happens, there is an increased risk of bone loss and osteoporosis. There are medicines that can treat or help prevent bone loss.
Even if your periods have stopped while you are on chemo, you may still be able to get pregnant. Getting pregnant while on chemo could lead to birth defects and interfere with treatment. If you are pre-menopausal before treatment and are sexually active, its important to discuss using birth control with your doctor. It is not a good idea for women with hormone receptor-positive breast cancer to take hormonal birth control , so its important to talk with both your oncologist and your gynecologist about what options would be best in your case. Women who have finished treatment can safely go on to have children, but it’s not safe to get pregnant while on treatment.
If you think you might want to have children after being treated for breast cancer, talk with your doctorbeforeyou start treatment. Learn more from our section on fertility concerns for women with cancer.
What Matters Most To You
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have chemotherapy after surgery
Reasons not to have chemotherapy
I want to do everything possible to treat my breast cancer.
I would rather wait and see if my cancer comes back before I have more treatment.
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What Is Breast Cancer
Breast cancer is a type of cancer that starts in the breast. It starts when cells in the breast begin to grow out of control.
Breast cancer cells usually form a tumor that can often be seen on an x-ray or felt as a lump. Breast cancer is most common in women, but men can get breast cancer, too.
Breast cancer cells can spread to other parts of the body and grow there, too. When cancer cells do this, its called metastasis.
Cancer is always named based on the place where it starts. So even if breast cancer spreads to the bones , its still called breast cancer. Its not called bone cancer unless it starts from cells in the bone.
Moving Genomic Testing Into Practice
This study is a big deal, said Dr. Timothy Byun, a medical oncologist with The Center for Cancer Prevention and Treatment at St. Joseph Hospital in Southern California, who was not involved in the study.
In an interview with Healthline, Byun said the study may result in fewer breast cancer patients getting chemotherapy, at least in European countries.
In the United States, many of us have already been using the Oncotype DX test to help guide our decisions, said Byun. It uses a 21-gene score. It gives similar information, but we dont know if theres a 100 percent correlation with the MammaPrint test.
Byun referred to the recent TAILORx Trial using the 21-gene test. It found that low-risk patients did well without chemotherapy.
That study showed the test could select a cohort of patients with a 99 percent chance of five-year survival without distant metastasis. For those women, the risks of chemotherapy arent justifiable.
Researchers are still waiting for this data to mature, cautions Byun.
We know that when oncologists see patients after surgery, we look at traditional clinical indicators to guide our decision-making process as to benefits and harms of chemotherapy, he said.
With the information currently available, its likely that some breast cancer patients get unnecessary chemotherapy.
Theres a caveat, according to Byun. Genomic studies, for the most part, have included only estrogen-receptor positive breast cancer patients.
Breast Cancer Survivors: Life After The Treatments End
The breast cancer treatments are over. Now what? Here’s how to return to your “new normal.”
Life after breast cancer means returning to some familiar things and also making some new choices.
The song says “It ain’t over ’til it’s over,” but when you’ve had breast cancer, you discover that it’s not even over when it’s over.
After a marathon of breast cancer diagnosis and treatment that may last six months to a year, you can hardly wait to get back to a normal life again. But the day of your last radiation treatment or chemotherapy infusion doesn’t mark the end of your journey with breast cancer.
Instead, you’re about to embark on another leg of the trip. This one is all about adjusting to life as a breast cancer survivor. In many ways, it will be a lot like the life you had before, but in other ways, it will be very different. Call it your “new normal.”
From your relationships with your family and your spouse to eating habits and exercise, breast cancer will change your life in ways that last well after treatment ends. How do you fight lingering fatigue? What should you eat to help prevent a breastcancer recurrence? Will you ever have a regular sex life again? These are just a few of the questions that may nag at you as you make the transition from breast cancer treatment to breast cancer survival.
How Does Chemotherapy Work
Chemotherapy works by attacking fast-growing cells in your body, including cancer cells. There are many different types of chemotherapy your medical oncologist will talk to you about whats most suitable for you. Sometimes more than one type of treatment may be effective for you, and you may be asked to decide which one to have. Your medical oncologist can tell you about the pros and cons of each.
Some questions you might like to ask include:
- What are the possible side effects of each treatment?
- How long is the course of each treatment?
- How will the treatment fit in with my lifestyle and personal circumstances?
Some chemotherapy drugs are given in tablet form, however, most are administered intravenously . As a result, it is useful to drink plenty of fluids, relax and keep your hands and arms warm, as this can help the nurse or doctor find your veins.
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Will The Nhs Fund An Unlicensed Medicine
It’s possible for your doctor to prescribe a medicine outside the uses it’s licensed for if they’re willing to take personal responsibility for this ‘off-licence’ use of treatment.
Your local clinical commissioning group may need to be involved, as it would have to decide whether to support your doctor’s decision and pay for the medicine from NHS budgets.
Page last reviewed: 28 October 2019 Next review due: 28 October 2022
Optimal Wait Time Before Surgery
We lead busy lives. Some people wonder if they can wait until an upcoming vacation to have surgery, or until their children are back in school. Others hope to wait until their insurance kicks in at a new job, or until they are able to find insurance. And not everyone feels quite ready to have surgery right after being diagnosed.
The average wait time until surgery has actually been increasing, with the average delay being 21 days in 1998, 31 days in 2003, and 41 days in 2008.
How long can you wait? Let’s look at studies of overall survival as well as special groups.
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Longer Term Side Effects
Tiredness is commonly reported during treatment. This may be a direct effect of the drugs or may be due to other factors such as disrupted sleep patterns.
- Try to get adequate rest but also try to exercise regularly. Go for a walk outside each day as this can actually give you more energy.
- Find something that you actually enjoy doing and also try to incorporate exercise into your usual day, e.g. walk upstairs rather than taking the lift, park further away from where you want to go and walk the extra distance. Build this up gradually.
- Your GP, practice nurse or a physiotherapist can work with you to devise a specific exercise plan for you.
- Let others help when your energy levels are low.
If your fatigue doesn’t allow you to exercise, discuss this with your GP.
Usually energy levels recover after treatment finishes but this commonly takes time. In some cases full recovery may take 12 months or more.
Some people notice they are having concentration and short-term memory problems following their chemotherapy. This is often referred to as chemo brain. The severity and duration of symptoms differ from person to person. For some people the symptoms are very mild and resolve soon after treatment stops, but others may find their daily life is noticeably affected for a much longer period, restricting their ability to return to work in their pre-treatment capacity.
Summary Of Surgery Timing
Though we don’t have a solid answer on how soon surgery should be done after a diagnosis of breast cancer , it would seem earlier surgery is ideal .
Delaying for a lengthy period of time can be dangerous, with studies finding that those who delay over six months are twice as likely to die from the disease. This is important to keep in mind for those who have breast lumps they are “observing” without a clear diagnosis. Any breast lump needs to be explained.
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Treating Stage Iii Breast Cancer
In stage III breast cancer, the tumor is large or growing into nearby tissues , or the cancer has spread to many nearby lymph nodes.
If you have inflammatory breast cancer: Stage III cancers also include some inflammatory breast cancers that have not spread beyond nearby lymph nodes. Treatment of these cancers can be slightly different from the treatment of other stage III breast cancers. You can find more details in our section about treatment for inflammatory breast cancer.
There are two main approaches to treating stage III breast cancer: