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How do drs decide if chemo is needed


Re: How do drs decide if chemo is needed


Hi Floyd1968


Thanks for posting


It’s understandable that you are feeling anxious whilst waiting for your results.


You may want to contact your breast care nurse or specialist team to check when your results will be back.


The decision to recommend chemotherapy is based on a few factors and not solely on the lymph nodes being involved.


You may be offered chemotherapy depending on factors such as; the size of the breast cancer, if the lymph nodes are involved and how many are affected.  The grade of your cancer and your Oestrogen receptor and HER2 status.


You may find it helpful to look at our booklet understanding your pathology report.

The benefit of chemotherapy may be clear for some people but less certain in other cases.

Your specialist team may use an online program to look at your individual benefit from having chemotherapy.  A commonly used program is Predict NHS.

If your specialist team has recommended Radiotherapy this will not be influenced by the recommendation to have chemotherapy.  As you have had a lumpectomy, radiotherapy will be given to reduce the risk of cancer returning in the breast.


Treatment may vary from country to country.  But it can also vary from person to person, depending on one’s individual situation. Which may be why you have been unable to find a definite answer. In the UK National guidance (NICE) helps healthcare professionals offer the best evidence based treatments to people.


Do call our free, confidential Helpline if you would like to talk this through or have any further questions. The number is 0808 800 6000.

Our opening hours are Monday to Friday 9am - 4pm and 9am -1pm on Saturday. Out of hours you can leave a message and we will call you back when we next open.


Best wishes




Breast Cancer Care Nurse


Please read the Ask Our Nurses disclaimer. This thread will now be closed from further replies. If you have any additional questions or would like to provide feedback, please start a new thread.

Community Champion

Re: How do drs decide if chemo is needed

Hi Floyd, The nurses will hopefully be along tomorrow to answer your question but I didn't want to read and run as I know how anxious this will be making you.


It depends on lots of factors but generally Chemo is suggested if there Is spread to any nodes as it's a sure sign that the cancer has begun to break off and go on a wander and Chemo would mop up any stray cells before they could do any harm elsewhere.

They will take in to consideration the grade of your cancer, the size doesn't always have any bearing, a tiny tumour can be a grade 3 and a much bigger one a grade 1. The more aggressive it is the more likely chemo will be recommended, did they tell you anything about the grade? 


I know it's so hard not to stress but it won't change anything and will just make the wait more miserable. 


Xx Jo 


How do drs decide if chemo is needed

Hi, I’m waiting on results of a SLNB that was done on the 24th of sept. Had a lumpectomy on the 13th aug to remove 8cm DCIS and they found 4mm invasive cancer, clear margins. Dr told me that I should be ok with rads and hormone therapy. Since I am still waiting for my results of the SLNB, my question is how many lymph nodes need to show evidence of cancer before the treatment changes from radiotherapy to chemo or both. I don’t know how many nodes the surgeon took but he was hoping for 3 maybe 4. I am Er+ Pr- HER2- and just starting menopause 50 yrs old. Nothing I have read seems to give a definitive answer. Does treatment vary country to country, hospital, surgeon? The waiting is causing anxiety. 😩