Will I need Chemotherapy for My Breast Cancer?

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We teach you how your tumor receptors, lymph nodes, genomic assays, and breast cancer stage indicates if you would benefit from chemotherapy.

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Questions for your Medical Oncologist and Breast Surgeon:
1. Would I benefit from chemotherapy?
2. What factors suggest I will benefit from chemotherapy?
3. What is the risk to my life if I do not undergo chemotherapy?
4. What are the advantages of “Neoadjuvant Chemo” before surgery?
5. Would a “Genomic Assay” help determine if I need chemotherapy?
6. What is chemotherapy?

Chemotherapy is the use of certain medications to treat cancer systemically, meaning throughout the whole body. If needed, chemotherapy is usually given after surgery for invasive breast cancer. It is a more intense cancer treatment than hormonal therapy (usually pills). Only a minority of breast cancer patients will ever need it. These complex decisions are ones you will make with your medical oncologist. You will make better treatment choices when you are informed about chemotherapy and hormonal therapy before meeting with your medical oncologist.

General indications for chemotherapy

We outline below some of the more common indications for needing chemotherapy. The decision to undergo chemotherapy also involves being healthy enough to tolerate the treatment. Deciding who needs chemotherapy and what type of chemotherapy to administer is one of the most difficult decisions made in medicine. Your medical oncologist will guide you.

Do my “receptors” suggest I need chemotherapy?

Once a breast biopsy is found to be cancerous, the pathologists will automatically run more tests on the same tissue to determine what “receptors” are expressed. Your receptor pattern is a key piece of information that comes early in your breast cancer journey. In about 30% of patients with an invasive breast cancer, the receptor pattern alone can strongly suggest that chemotherapy will be needed regardless of what is found at surgery. The key points regarding receptors are outlined below.

Estrogen Receptor Negative (ER -) tumors (20%) do not respond to anti-estrogen oral medications that are essential in treating estrogen receptor positive (ER +) tumors. Quite simply, patients with ER negative tumors will benefit from chemotherapy if they are healthy enough to tolerate it. ER negative tumors are more aggressive cancers, but respond more favorably to chemotherapy than ER positive breast cancers.

HER2 Receptor Positive (HER2+) tumors (20%) are very responsive to chemotherapy when paired with new breakthrough drugs that target these tumors, such as Herceptin and Perjeta. The same holds true even if a HER2-positive tumor is also Estrogen Receptor positive (ER+). HER2+ tumors are more aggressive cancers, but we now can treat them more effectively with chemotherapy and new drugs that are “targeted” to destroy HER2-positive cancers.

“Triple Negative” (ER-)(PR-)(HER2-) tumors are fast growing tumors that are usually treated with a specific chemotherapy regimen. These tumors are not responsive to hormonal therapy at all, but may be sensitive to chemotherapy.

What if cancer is detected in the lymph nodes?

If you have “lymph node positive” breast cancer, it is likely you will be offered chemotherapy. Premenopausal women and those with multiple “positive” lymph nodes generally benefit from chemotherapy. If your breast surgeon detects cancer in your lymph nodes before surgery, there may be specific advantages to undergoing “neoadjuvant chemotherapy.”

“Inflammatory Breast Cancer” requires chemotherapy
If you have been diagnosed with inflammatory breast cancer, the first step is neoadjuvant chemotherapy before surgery. This type of cancer has a high likelihood of spreading to the lymph nodes and other parts of the body. Starting chemotherapy as soon as possible is essential to treating this aggressive breast cancer. A mastectomy is performed after chemotherapy, followed by radiation to the area of the mastectomy to lessen the chance of cancer growing back in that area.

What are the advantages of “neoadjuvant chemotherapy”?

Neoadjuvant chemotherapy is when chemotherapy is given before surgery, not afterwards. There are specific advantages to neoadjuvant chemotherapy in appropriately selected patients.

How can a genomic “Oncotype DX” test be helpful?

Patients who have a small, estrogen receptor positive, HER2 receptor negative tumor and no evidence of cancer in their lymph nodes may benefit from an Oncotype DX genomic assay. This cutting-edge test looks deeper into breast cancer cells to better identify people who may benefit from chemotherapy with ER+, HER2 – breast cancers.
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I declare healing for every one diagnosed with breast cancer in Jesus name! 🙏🏼

Rampaigee
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This is a REAL doctor, I love the way he explains things. So easy to understand.

alechamid
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What a lovely bedside manner, thank you for explaining things so much better,
I wish other Doctors spoke so kindly. I wish you were my Doctor.
Prayers to those going through the same. ~Karen🌹

TheHighPriestessStudio
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I'm newly diagnosed breast cancer. Thanks for the best info I learned Doctor

clarissllena
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Thank you for making videos like this so people can make informed decisions.

jamiecalvert
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Thank you so much for this video presentation. I am one who is a breast cancer in 2021 and it was stage 2. After 6 cycles of chemo and went in for mastectomy. I am beginning to understand all this presentation you have put. My doctors were never vocal and advisable. I wish I can get the best treatment from your end for the sake of my children. Thank you for all these information 😊

slogenblake
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Dr.Williams what a gift from God. I am 71 n just had a lumpectomy. I was positive for Estrogen n Progesterone. Went back to my surgeon to have stitches out n only saw her nurse. I have so many questions I wanted answered n wasn’t able to see her. I’m mad, upset n feel this was wrong of her to be done with me. What should I do?

KTen-cmwx
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My mom just got diagnosed with stage 2 . We have a Dr appointment soon for the first time after she found out. I’m getting prepare for her Dr visit and thank to all this good information, now I have a good understanding of this and what to ask. THANK YOU!

CariSalgado
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I have just got my results today my the lump was cancer's but non on my limp bones dose this definitely mean the cancer hasn't spread good luck to all who's reading this x

georgieprice
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Thank God for you, Dr. This video explained my situation exactly and is helping me decide whether or not chemo is right for me. Genomic assay portion was very helpful.

sp
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God bless this Dr Williams for his knowledge and his great personality.

SwrPwr
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I was offered Chemo and I couldn’t do it. I work a very physical job one on one with people and no else contributes to my support, or would be able to care for me during treatment so I said no. Another lump came up near the lymph node they removed last week, and now I’m under duress. Please pray I make good decisions and can overcome my anxiety and obstacles.

ishouldbesleeping
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Such a peaceful being he seems❤, very comforting for the eye&ear👌

vibes
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According to videos by women who are having treatments, the side effects of chemo can be debilitating, including headaches so bad they have to wrap their hairless heads in ice. Hormonal therapy is even worse. Women say their joints hurt so much they can't walk, and that lasts for 10 years. I am ER+, PR+, HER2+. But I am 66. I doubt I will get chemo if I can't do it orally, and I'm pretty sure I won't do hormonal therapy. It's about quality of life at my age.

do
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I cried and hugged my oncologist when my OncotypeDX number was a 9. He told me the mastectomy was my cure. Grateful and blessed.

yvonnequinones
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My mama have a breast cancer and her doctor advise her to undergo chemo but some of our relatives and the people we know some of then suggested to not undergo chemo because it can make my mama weak and may cause of death, that what they said so here i am searching for answer and i take note all of it so that i could ask the doctor fr advice . I love my mama so much and im so afraid about her situation im so afraid .

shienlygracetorres
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Thank you for this so easily digestible explanation. You have a wonderful way of delivering even the "hard to hear" information.

Appreciate. 🙏🏾

JackyHapy
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Thank you. So well explained, which most of doctors fail to do so..

sambchu
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I am so thankful for your videos. Your education has helped to get educated, so I can focus more on what my dr is telling me versus focusing on the fear of the unknown. God bless you and thanks a million

Myname-wz
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Thank you so much for all your ' lesons'. It helps me a great deal in this proces.

Talal