Hi Eli thank you for your direct to doctor query. Sorry to hear about your breast cancer diagnosis.
Whether you need chemotherapy depends on the stage of your cancer and specific cancer characteristics. I agree with Dr Lim Hwee Yong , there are very established treatment algorithms that is based on good scientific data according to breast cancer type.
I don't know the details of the histological report of your breast cancer but if you are still in a quandary about chemotherapy there are tests available to test genes in the cancer to predict risk of cancer coming back or to predict the likelihood of the benefit of chemotherapy. For example, for patients with early-stage, ER-positive, HER2-negative, node negative, and node-positive (1-3) breast cancer Oncotype Dx can be ordered.
The subject matter expert for chemotherapy would be oncologists like Dr Lim. So do get some opinions from them.
My input from my area of expertise surgical oncology is I would want to make sure that the cancer is removed with sufficient margins (completely removed) as that would impact on you cancer outcome. There is no reason why adequate margins cannot be obtained.
And wearing my plastic surgeon hat, I would say that chemotherapy is not a problem if you have had a reconstruction neither is it a problem if you are planning to do reconstruction after your chemotherapy treatment.
Wishing you all the best
