Stage 1 BC on >70yo---adjuvant therapy?

My mother's diagnosis came in, and it's stage 1 breast cancer. It was
a small lump, removed with clear margins, and the lymph nodes they
tested were all uninvolved. I thought that would mean she was done.
However, her doc has her starting a course of oral chemotherapy (don't
know what kind) and plans for radiation as well. Does this make any
sense?

---
CSM

csm7532@hotmail.com wrote:

> My mother's diagnosis came in, and it's stage 1 breast cancer. It was
> a small lump, removed with clear margins, and the lymph nodes they
> tested were all uninvolved. I thought that would mean she was done.
> However, her doc has her starting a course of oral chemotherapy (don't
> know what kind) and plans for radiation as well. Does this make any
> sense?

NCCN Guidelines are here, CSM
http://www.nccn.org/patients/patient_gls.asp
J

On Feb 16, 2:37 pm, csm7...@hotmail.com wrote:
> My mother's diagnosis came in, and it's stage 1 breast cancer. It was
> a small lump, removed with clear margins, and the lymph nodes they
> tested were all uninvolved. I thought that would mean she was done.
> However, her doc has her starting a course of oral chemotherapy (don't
> know what kind) and plans for radiation as well. Does this make any
> sense?
>
> ---
> CSM

Sorry to hear about your mom, Stage 1 the prognosis is very good.
Radiation after lumpectomy is standard. The chemotherapy proposed
could be hormonal therapy in the form of a anti estrogen pill such as
Tamoxifen. I didn't have radiation since I had a mastectomy and I
didn't have hormonal therapy since my tumor didn't respond to
hormones.

Questions to have:
What the tumor ER( estrogen) and PR (progestrone) sensitive, the
outlook is more favorable if hormone sensitve.

HER/2 status - you want it to be neg.

Alex

On Feb 16, 4:28 pm, J <nexsw@nvalid,anon> wrote:
> csm7...@hotmail.com wrote:
> > My mother's diagnosis came in, and it's stage 1 breast cancer. It was
> > a small lump, removed with clear margins, and the lymph nodes they
> > tested were all uninvolved. I thought that would mean she was done.
> > However, her doc has her starting a course of oral chemotherapy (don't
> > know what kind) and plans for radiation as well. Does this make any
> > sense?
>
> NCCN Guidelines are here, CSM http://www.nccn.org/patients/patient_gls.asp

Thanks. That's a great site---well set up, easy to use, and plenty of
information. This is reassuring, to at least know that they're
following guidelines. I guess either the stages have different
effects for different cancers, or that treatment agressiveness varies
by cancer.

---
CSM

csm7532@hotmail.com wrote:

> On Feb 16, 4:28 pm, J <nexsw@nvalid,anon> wrote:
> > csm7...@hotmail.com wrote:
> > > My mother's diagnosis came in, and it's stage 1 breast cancer. It was
> > > a small lump, removed with clear margins, and the lymph nodes they
> > > tested were all uninvolved. I thought that would mean she was done.
> > > However, her doc has her starting a course of oral chemotherapy (don't
> > > know what kind) and plans for radiation as well. Does this make any
> > > sense?
> >
> > NCCN Guidelines are here, CSM http://www.nccn.org/patients/patient_gls.asp
>
> Thanks. That's a great site---well set up, easy to use, and plenty of
> information. This is reassuring, to at least know that they're
> following guidelines.

Well, I don't know what you clicked on there. There's decision trees.
J

> I guess either the stages have different
> effects for different cancers, or that treatment agressiveness varies
> by cancer.
>
> ---
> CSM

On Feb 17, 9:43 am, J <nexsw@nvalid,anon> wrote:
> csm7...@hotmail.com wrote:
> > On Feb 16, 4:28 pm, J <nexsw@nvalid,anon> wrote:
> > > csm7...@hotmail.com wrote:
> > > > My mother's diagnosis came in, and it's stage 1 breast cancer. It was
> > > > a small lump, removed with clear margins, and the lymph nodes they
> > > > tested were all uninvolved. I thought that would mean she was done.
> > > > However, her doc has her starting a course of oral chemotherapy (don't
> > > > know what kind) and plans for radiation as well. Does this make any
> > > > sense?
>
> > > NCCN Guidelines are here, CSMhttp://www.nccn.org/patients/patient_gls.asp
>
> > Thanks. That's a great site---well set up, easy to use, and plenty of
> > information. This is reassuring, to at least know that they're
> > following guidelines.
>
> Well, I don't know what you clicked on there. There's decision trees.
> J
>
> > I guess either the stages have different
> > effects for different cancers, or that treatment agressiveness varies
> > by cancer.
>
> > ---
> > CSM
CSM saw the guidelines, I am glad I posted that site despite the
negativity I got from J and Steph
http://groups.google.com/group/alt.s...1fc61c306bf0bb

csm7532@hotmail.com wrote:

> On Feb 16, 4:28 pm, J <nexsw@nvalid,anon> wrote:
> > csm7...@hotmail.com wrote:
> > > My mother's diagnosis came in, and it's stage 1 breast cancer. It was
> > > a small lump, removed with clear margins, and the lymph nodes they
> > > tested were all uninvolved. I thought that would mean she was done.
> > > However, her doc has her starting a course of oral chemotherapy (don't
> > > know what kind) and plans for radiation as well. Does this make any
> > > sense?
> >
> > NCCN Guidelines are here, CSM http://www.nccn.org/patients/patient_gls.asp

Just a word of warning. Many of these guidelines are either non-evidence
based, or fly in the face of the evidence. That's not necessarily a
criticism, as most "guidelines" have those problems. Many of these really
only have validity for the US context

Just about the most evidence-based guidelines which exist, and are very
regular reviewed and updated are at
http://www.bccancer.bc.ca/HPI/Cancer...es/default.htm

>
> Thanks. That's a great site---well set up, easy to use, and plenty of
> information. This is reassuring, to at least know that they're
> following guidelines. I guess either the stages have different
> effects for different cancers, or that treatment agressiveness varies
> by cancer.
>
> ---
> CSM

On Feb 17, 4:30 pm, J <nexsw@nvalid,anon> wrote:
> csm7...@hotmail.com wrote:
> > On Feb 16, 4:28 pm, J <nexsw@nvalid,anon> wrote:
> > > csm7...@hotmail.com wrote:
> > > > My mother's diagnosis came in, and it's stage 1 breast cancer. It was
> > > > a small lump, removed with clear margins, and the lymph nodes they
> > > > tested were all uninvolved. I thought that would mean she was done.
> > > > However, her doc has her starting a course of oral chemotherapy (don't
> > > > know what kind) and plans for radiation as well. Does this make any
> > > > sense?
>
> > > NCCN Guidelines are here, CSMhttp://www.nccn.org/patients/patient_gls.asp
>
> Just a word of warning. Many of these guidelines are either non-evidence
> based, or fly in the face of the evidence. That's not necessarily a
> criticism, as most "guidelines" have those problems. Many of these really
> only have validity for the US context
>
> Just about the most evidence-based guidelines which exist, and are very
> regular reviewed and updated are athttp://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/default.htm
>
>
>
> > Thanks. That's a great site---well set up, easy to use, and plenty of
> > information. This is reassuring, to at least know that they're
> > following guidelines. I guess either the stages have different
> > effects for different cancers, or that treatment agressiveness varies
> > by cancer.
>
> > ---
> > CSM

These are the standard US Oncologist use, I see 12 pages of
references. for breast cancer Here is page one

1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA
Cancer
J Clin. 2006;56:106-130.
2. Early Breast Cancer Trialists' Collaborative Group. Effects of
chemotherapy and hormonal therapy for early breast cancer on
recurrence and 15-year survival: an overview of the randomised trials.
Lancet. 2005;365:1687-1717.
3. Gail MH, Costantino JP, Bryant J, et al. Weighing the risks and
benefits of tamoxifen treatment for preventing breast cancer. J Natl
Cancer Inst. 1999;91:1829-1846.
4. Dupont WD, Page DL. Risk factors for breast cancer in women with
proliferative breast disease. N Engl J Med. 1985;312:146-151
5. Greene FL, Page DL, Fleming ID, et al. AJCC Cancer Staging
Manual. 6th ed. New York, NY: Springer-Verlag; 2002.
6. Singletary SE, Allred C, Ashley P, et al. Revision of the American
Joint Committee on Cancer staging system for breast cancer. J Clin
Oncol. 2002;20:3628-3636.
7. Singletary SE Greene FL, Sobin LH. Classification of isolated tumor
cells: clarification of the 6th edition of the American Joint
Committee on
Cancer Staging Manual. Cancer. 2003;98:2740-2741.
8. White J MM, Morrow M, Moughan J, et al. Compliance with
breastconservation
standards for patients with early-stage breast carcinoma.
Cancer. 2003;97:893-904.
9. Wilkinson NW, Shahryarinejad A, Winston JS, et al. Concordance
with breast cancer pathology reporting practice guidelines. J Am Coll
Surg. 2003;196:38-43.
10. Giordano SH, Valero V, Buzdar AU, Hortobagyi GN. Efficacy of
anastrozole in male breast cancer. Am J Clin Oncol. 2002;25:235-237.
11. Giordano SH, Buzdar AU, Hortobagyi GN. Breast cancer in men.
Ann Intern Med. 2002;137:678-687.
12. Rosai J. Borderline epithelial lesions of the breast. Am J Surg
Pathol. 1991;15:209-221.
13. Schnitt SJ, Connolly JL, Tavassoli FA, et al. Interobserver
reproducibility in the diagnosis of ductal proliferative breast
lesions
using standardized criteria. Am J Surg Pathol. 1992;16:1133-1143.
14. Haagensen CD, Bodian C, Haagensen DE, Jr. Breast carcinoma.
Risk and detection. Philadelphia, PA: W.B. Saunders;1981
15. Bradley SJ, Weaver DW, Bouwman DL. Alternatives in the surgical
management of in situ breast cancer. A meta-analysis of outcome. Am
Surg. 1990;56:428-432.
16. Chuba PJ, Hamre MR, Yap J, et al. Bilateral risk for subsequent
breast cancer after lobular carcinoma-in-situ: analysis of
surveillance,
epidemiology, and end results data. J Clin Oncol. 2005;23:5534-5541.
17. Anderson BO, Calhoun KE, Rosen EL. Evolving concepts in the
management of lobular neoplasia. J Natl Compr Canc Netw.
2006;4:511-522.
18. Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for
prevention of breast cancer: report of the National Surgical Adjuvant
Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998;90:1371-
1388.
19. Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for the
prevention of breast cancer: current status of the National
Surgical.........and this is only page one.

>
> Just a word of warning. Many of these guidelines are either non-evidence
> based, or fly in the face of the evidence. That's not necessarily a
> criticism, as most "guidelines" have those problems. Many of these really
> only have validity for the US context
>
> Just about the most evidence-based guidelines which exist, and are very
> regular reviewed and updated are athttp://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/default.htm
>
>

I looked at the first the pages and here are some of the references,
Nothing has changed in cancer care in Canada since the 1990s????

reference:

1.
(BC Med J 1997;39:496-500)



Hislop TG, Coldman AJ, Warren Burhenne LJ, et al. Mammographic
density and risk of breast cancer within the Screening Mammography
Program of British Columbia. BC Med J 1997;39:496-502.
2. Henderson BE, Pike MC, Bernstein L, Ross RK. Breast cancer. In:
Schottenfeld D, Fraumeni JF Jr. (Eds.) Cancer Epidemiology and
Prevention. 2nd Ed, 1996. Oxford University Press, Oxford Pp 1022-
1039.