Breast Cancer Advice Center

Do Oncologist recommend chemotherapy for every stage 1 breast cancer patient?

Also, are stage zero cancer the only cancer that oncologist don't recommend chemotherapy for?

Public Comments

1. They push the treatment because it equals billable dollars for them. They don't care about the result.
   
   Go on a heavy-duty anti-oxidant, and homeopathic nutritional program.... All in, seriously over-kill nutritional program.
2. No not necessarily.
   
   It depends on the individual patient’s situation and how much they will benefit from chemo; this depends on several factors, which include stage but also grade and lymph node involvement
   
   In some circumstances it will be recommended as its benefits for the patient are clear, and the percentage by which it will increase survival statistics is significant.
   
   In others the benefits of chemo are less certain or quite small, and these patients are not always stage 0; some people decide not to go ahead with it after weighing up the likely benefits against any potential side effects.
   
   In my case chemo was strongly recommended as my cancer was stage and grade 3 with several lymph nodes involved. A friend who was stage 1 with one node involved was not recommended to have chemo.
3. It is fairly complicated decision process.. here are guidelines from the American Cancer Society website..
   http://www.cancer.org/docroot/CRI/conten...
4. Honey, the second answer that was given to u says it all. Listen to it.
5. No. And as an oncologist I really resent trooper's completely idiotic response.
   
   The breast cancer staging does provide for a risk assessment--in the old days, higher the stage, higher the risk, and was felt more need for more aggressive therapy.
   Nowadays, we are learning about the biology of tumors more and more. Size of cancer, type, lymph node involvement, vascular invasion all are important, but the bottom line is that you can take two tumors of same size and same everything we classically measure, and they can behave very differently. There are biological factors at work that we are slowly unravelling.
   Many new tests are available, such as Oncotype Dx (www.oncotypedx.com), which help us categorize risk for patients. This test is appropriate in many stage I patients, if they are positive for the estrogen receptor. If you have that, then you are a candidate for hormonal therapy also.
   
   In my practice, a risk assessment is done. It is generally true that the higher the risk, the higher the benefit of chemotherapy, but for every patient this is a personal decision. Some will not take chemo for any reason, others will do anything to keep breast cancer from coming back.
   
   I have not offered chemotherapy to patients with stage II and III disease many times because risk was felt too great and benefit small.