low oncotype score of 10 chemo or not

Sweetie1972

With a low oncotype score of 10 I'm not sure if I should do chemo.I'm freaked out that pathology report says I have angiolymphatic invasion, lymphovascular invasion and perineural invasion!

Anyone have any suggestions? I'm 40 with 4 children. I don't want any regrets! Thanks

Tiffany

edwards750

Trm - what is your ONC recommending? That is a very low score but I have read posts from women who had low scores and still had chemo because of the kind of bc they had. You are young so ONCs tend to recommend aggressive treatment. My Oncotype score was 11; I had non-aggressive cancer and the tumor wasnt that large. My ONC recommended RADS - I had 33 of those. No you dont want to look back and wish you had had chemo or rads. Neither one is a fun thing but throwing something else at our bc to help prevent recurrence is a necessary precaution. BTW I was Stage 2, Grade 1 IDC. Diane

Sweetie1972

@Edwards I see my MO on Monday and RO ON Wednesday. I had BMX on April 3. I guess I'm just paranoid about the what if's

pupmom

Trm, it's your young age that is a concern. I would definitely listen to my onc's advise if I were you! Best wishes sweetie!

Sweetie1972

Yorkie- funny you called me sweetie that's my maiden name

ppplocke

I had Oncotype of 8. Did chemo. I was 39 at diagnosis. No family history. BUT I have three children. That is why I chose to leave no stones unturned. Do the chemo. You have a node positive...which means your cancer left the reservation. Do all you can to stop it.

Cuetang

Trm-- good luck with the MO and RO visits! I had an Oncotype score of 8 and did not do chemo (I'm 33). However, my pathology report did not show any of the invasions that you listed and no nodes. I was one that made the tumor board review my case again to make sure that I didn't need chemo. If I had shown that LVI or anything similar was present, along with a positive node, I would have probably seriously questioned the MO and leaned towards chemo. This is seriously a damned if you do and damned if you don't thing about BC that sucks. Best wishes!!

Rose_d

Tiffany,



Good luck with your appointments. I was 39 at diagnosis with 1 positive node and a tiny bit of LVI. My doc wouldn't even do the oncotype test. Said the combo of my age and the lymph node meant chemo.



The one thing she said that made me feel better was - the oncotype test is supposed to measure the likelihood of recurrence within 10 years. I am not worried about 10 years for you, I'm worried about 20-30 years. Important news for someone with 3 little kids!



Best of luck today,



Rose

Sweetie1972

Thanks all for your well wishes!!:) I will post what my mo suggests later, but I'm leaning towards chemo. I don't want to leave any stones unturned for my children's sake they need there mother to be here!!

Gully

Trm- Just to chime in. My stats are similar to yours except mine is IDC, with no nodes involved. My oncotype was 19 on one side and 5 on the other (bilateral BC). I also had focal LvI. Age 45 but physically fit. My onc said lets treat you like you are 35 and hit it with both barrells. I am doing Cytoxan and Taxotere for four rounds) I have done one already and feel good. For me I did not want to kick myself later if one of those grade 2 cells slipped away in that point of focal LVI and made me stage 4 in a couple of years! My kids are worth it! (twins age 14) If it comes back I cant kick myself for not doing everything I can to stay with my family. Good luck with your decison its a tough one.

Sweetie1972

Thanks Gully

Sweetie1972

So I did not like the no at all. He wanted to know why my surgeon referred me to him( I don't know why don't you ask her) he said I'd need 10 yrs of tamoxifen and whatever the shot is to stop your ovaries for 5 yrs. When I was asking him a question he actually rolled his eyes at me!! I've already scheduled a second opinion for Wednesday and if he says the same course of treatment then so be it! Just hoping he doesn't treat me like a statistic and treats me like a person

Sweetie1972

I see ro on Wednesday also. I had positive margin at posterior sitting on pectoral muscle. Surgeon is not sure if I'll need rads or not. This is all so overwhelming, sometimes I just want to curl up in a corner and cry. But I can't I have 4 children(15,13,10and 9) I need to be strong for!!

bevin

HI there, I also had over 2cm tumor but grade 3, and Onco score 11. Not sure why the discordance beween the two.  I didnt have any nodes effected and no LVI was present.  I did have 1 Onco say that he recommended  chemo as I was young at diagnosis (45) and all offered chemo but the other 2 said they'd be comfy if I didn't have it due to my pathology and felt the gained benefit wasnt enough.  I elected no chemo as the risks seemed to outbid the benefit gained and the side effects of chemo scared me. 

I will share too that if I had LVI or nodes, I'd have gone with Chemo. I did have alot of radiation, 38 rounds and am on antihormonals.  I have a young child too and I know its scary to also ensure your considering their future as well in this decision making.

I'd definately see 2 or 3 Oncologists to be sure you're comfortable with the recommendations. To have someone  roll their eyes at me would not be someone I'd personally trust my care to. I'd have probably called him on it and asked why he was doing that. That kind of stuff bothers me. Doctors have to remember they work for you and you pay their salary.  You'll be with your Onco for a long time, so good to ensure you get along and trust him or her. Good luck to you and keep us posted.

voraciousreader

Trm... Your oncologist was basing his opinion on the following. Based on the Oncotype DX score of 10 your risk of chemo will outweigh your benefit. Instead, based on the ongoing SOFT trial, there are a number of sisters who are being recommended ovarian suppression. You can read more about ovarian suppression in the NCCN guideline footnotes. You can read the guidelines if you go to the NCCN website and register. Look for the profession version of the 2013 breast cancer treatment guidelines. Preceding the professional version is a red logo. Furthermore, your physician is basing his opinion about 10 years of Tamoxifen based on the recent publication of the landmark Atlas trial.

MTM710

The onco 10 is great for the future, but with so much invasion the microscopic cancer cells can be hiding.  Chemo has little effect on recurrence but can kill off the little microscopic terrorists that can't be seen in the scans.  Good luck!

cascam12

trm. Private messaged u