A close friend just had a lumpectomy for a small (2 cm) breast tumor. Her doctor, who sounds very well qualified, is recommending partial breast radiation and four months of chemo to follow up, which the doc is calling aggressive treatment. Lymph nodes appear to be cancer free after a check of the sentinel node.
But I can't shake the feeling that maybe this treatment isn't aggressive enough; my friend is only 41 and has a long life yet to live. I know she feels this way too; she's wondering if she should ask for full breast irradiation, tamoxifen, etc. Anyone out there have insights or thoughts about how to decide what's aggressive enough? She's still waiting on results for HER-2 status etc; she tested negative for BRCA. Thoughts?
I would recommend getting a second opinion. There's very little downside and if they are in agreement, you and your friend have a lot of peace of mind. Maybe you'll find our article on getting a second opinion for cancer diagnosis helpful.
Doctors are not infallible and are usually making value judgements about risk. In my opinion, a good doctor will layout several options with all their pros and cons, make a recommendation, and allow you to make a decision.
It sounds like your friend is still waiting to find out some important information from the pathology report, which will help a lot with making decisions about prognosis and treatment.
The reason I say this is that the pathology report should tell her important things like the tumor's stage and grade, whether she is HER2/neu-positive or negative, and her estrogen receptor status. These are all important factors she and her oncologist will use to decide about lumpectomy vs. mastectomy, and in making decisions about radiation, chemotherapy, and hormone therapy. (Sometimes after a lumpectomy, the pathology report will reveal that the surgeon was not able to remove the whole tumor and will recommend a mastectomy.)
Communication is really important when it comes to treating a disease as complex as cancer, and it sounds like your friend needs to have a more in-depth talk with her oncologist so she has a chance to ask questions about her treatment options. She might find our article listing the top 20 questions to ask your oncologist helpful.
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