oncotype:16, (hormone driven w/one 3mm lymph node

mmvh

I am getting differing advice, 2 oncologists have suggested I take part in a study to see if chemo benefits those with a lower Oncotype score (under 25) with 3 lymph node involvement or less and hormone driven breast cancer.They are fine with me being in the group that take chemo or does not along with hormone treatment.

Anyone else faced this situation? One oncologist suggests I do chemo and 2 suggest I do this study.

Lenn13ka

oncotype 17 4mm lymph node positive. You are talking about the SWOG trial. I got 6 opinions split 3/3. Top Dana Farber Dr. Said no problem skipping chemo. Was going to do trial but ended up just not doing chemo. I too was Er/Pr positive. It is a very common discussion days. My MO said it is 50/50 right now throughout the entire country. Second opinions outside of your facility might be helpful. Go to the best near you. Good luck. It is a tough decision.

Moderators

mmvh, welcome to Breastcancer.org.

Following up on Lenn13ka's advice, if you want to learn more about the why, where, when and what to expect from a second opinion, check out the the main Breastcancer.org site's section Getting a Second Opinion.

• The Mods

Sandymomto3

mmvh....I am currently in that trial. I had 3 positive nodes. I was computer randomized to the non chemo group. After lots of thought and discussion I entered the next step of the trial. My Oncotype is a 13. 18 and below is deemed low. Not sure where you live and what medical care/facilities you have access to, but a second opinion if you are unsure is never a bad idea. These boards are full of wonderful ladies...tons of information and support.

coraleliz

mmvh-The SWOG study was just beginning when I was diagnosed. Not very many centers participating. It was really hard for me to get the oncotype test because I was node positive. Two nodes positive(3mm). My oncotype was "4". I was leaning away from chemo & was only going to do it for a high(or possibly intermediate-because I had 2 tumors) score. I wanted to be part of the SWOG study but I didn't meet the criteria.

I assigned myself not to get chemo. Taking Tamoxifen for 5yrs.

mmvh

Wow, this has been really helpful, it sounds like a topic that many are dealing with. I am finding that the oncologists (the 2 who recommend the study as opposed to the one who suggested chemo) are more ok with not doing the chemo in my situation than my OB/GYN and internist who's opinions I have also sought.

How many opinions are enough? I have gotten 3 now in my area. Is that enough?

Thank you everyone who has commented and I wish you the best of health!

Lenn13ka

mmvh - the OB/GYN - Internist are looking at "standard of care" -which would be chemo because of your node. My primary care doc was the same way. I had already made my "No" decision and she was a little concerned until she learned more from the MO's. I got one opinion outside of my facility (I am MGH so I got one at Dana Farber). I had a split decision at MGH and the no vote from Dana was the deciding factor. They are one of the tops in the country and I saw one of their best Dr.s for my second opinion.

Get as many opinions as you need to feel comfortable with your decision. Are you satisfied with your Doctors? Do you trust them? Are all your opinions from the same hospital?

You are right. This is a discussion that many 1-3 positive node patients with low oncotypes are having as new research is showing that there is not much difference between node negative  and node positive  as far as benefit from chemo. Mine was 1-2%. You can find graphs on the internet if you punch in postive node/low oncotype. Usually something from Genomic Health will come up ( or it may be on your Oncotype dx report -did your Dr. go over it with you?)

You are not alone. A lot of us have to make this decision. Take all the time you need.

mmvh

Thanks, good advice, I agree it comes back to the standard of care. In fact, the 2 MOs that suggested the study to me did not really say no to chemo but said it would be fine if I did not end up in the group doing chemo. However, I can, of course, simply turn down the chemo.

Anyone in this situation in the Washington, DC/suburban Maryland area? If so, I would love to compare notes on the doctors I have seen.

cenerentola72

Hi , i live in italy.

I amm 41 years old with 3 node positives. i am waiting for oncotype dx  at the ende of the week and  then i decide if chemoterapy or not

can i tell you if you have decide ? Your age ?

Martessa2553

I was stage 1 grade 1 with no lymph nodes involved.  Onco wanted me to do chemo and kept saying no.  She then ordered the Oncotype DX test which came back at 5 percent in 5 years.  Onco said I did not need chemo but would need to do hormone therapy (anastrozole 1mg) for 5 years to which I agreed.