Obstetrician and Gynecologist Questions Breast Cancer

What Breast Cancer treatment is recommended?

I was diagnosed with Stage 2 Breast Cancer. I am estrogen positive and HER2 negative. I had a Lumpectomy and ANC done. I have clear margins but 6 nodes are positive out of 22 removed. What is the best treatment given my diagnosis?

Female | 44 years old

6 Answers

You need chemotherapy and aromatase inhibitors after.
Broadly speaking you will need both chemotherapy to be followed by radiation and finally with Tamoxifen. You should consider talking to a genetic counselor for genetic testing due to your young age. Current treatment regimens are very successful in treating even node positive cancer, so don't be discouraged.
There are many factors taken into consideration in charting a course, a master plan. Your oncologist would be able to review and make the best recommendation. Radiation therapy and chemotherapy/intravenous and long-term oral medications need to be discussed. The other important issues are: the ovarian function and testing for the BRCA gene mutation, along with other preventive health measures.
Adjuvant chemotherapy (in our practice, we use 4 cycles of Adriamycin and Cytoxan followed by 12 cycles of Taxol) followed by radiation therapy, breast and regional lymphatics, and 5 years of hormonal therapy. Your medical oncologist may use different regimens. Because of your age and stage, she definitely needs chemotherapy for systemic disease and radiation to breast and lymph node areas in axilla and supra-infraclavicular areas to prevent local and regional recurrences.
I would highly recommend chemotherapy followed by breast and lymph node radiation. Your high number of positive lymph nodes is the driving factor in that decision.
You should get chemotherapy and hormone therapy. But every case is different and specific. But in general, you should get chemotherapy followed by radiation to the rest of your breast and hormone therapy with an anti-estrogen for the next 5-10 years.