Oncotype Score 23 - What now?

Marcygiff

I just got my score of 23. I am 48, had double mastectomy with DIEP on August 13, ER/PR+ HER-, one lymph node positive. Doctor says difference in Tamoxifen alone and Tamoxifen & Chemo is only a 1% difference but the decision on whether to do it or not is up to me.

Just like all the other decisions I've had to make with since I was diagnosed, I once again fit in that grey area where no one can really help. I'm giving myself a headache trying to research all the information I can and make an informed, wise decision. I would welcome any insight or information!

Marcy

Dx 6/2/14, IDC (and some DCIS), 1.5cm, Stage II, Grade 2, 1/15 nodes, ER+/PR+, HER2-

Surgery 8/13/14, BLM, Immediate DIEP reconstruction

keepthefaith

marcygiff, Here is a link for a calculator that might help. My onco was 21; my MO told my 4-5% benefit with chemo; chart says I reduced my cancer mortality in 15 yrs by 4% with chemo.  You can also ask about getting a mammaprint test done. Hard decisions. Good luck!

www.lifemath.net/cancer/breastcancer/therapy/

MsPharoah

Hi Marcy, this decision is difficult and important.  I had a recurrence score of 24, which gave me a recurrence risk of 16%.  My oncologist calculated that chemo would further reduce my risk to just under 13%, which was for me enough to do chemo.   I am not sure what the 1% reduction signifies...statistics can be so misleading so I can't say for sure that it is incorrect.  

My recommendation is that you ask for the mammaprint test.  It has no intermediate result, just high or low risk.  It bothers me that the Oncotype DX test is in such widespread use with so many people landing in the dreaded gray zone. They should use Mammaprint alone IMHO.

MsP

JohnSmith

Did you discuss with your MO about getting 2nd opinion diagnostic tests? It may help with your decision.

These two tests come to mind:
1. Prosigna, by NanoString Technologies. www.prosigna.com
2. MammaPrint (Symphony), by Agendia. www.agendia.com

hyphencollins

Hi Marcy.  Have you considered a second opinion from another doctor?  That may give you an additional perspective to consider when deciding. FWIW I have very similar stats including an oncotype of 23.  My MO said at this point she couldn't not recommend chemo with one positive node and anything other than a low oncotype.  I just got a second opinion at Dana Farber and chemo was also recommended.  Both indicated that in the future they expect to better understand the need and impact of chemo for node positive intermediate oncotype tumors when the RxPonder trial is completed.  Best wishes.

mmtagirl

interesting.  Be careful about looking at stats with no lymph node involvement vs when 1-3 are impacted.  I signed up for the RxPonder trial trying to avoid chemo but ended up in the chemo arm.  Tomorrow 3 weeks PFC.  Don't let chemo scare you,  mind you, it's a bitch but very doable.  At least for me.  New studies Also out this year indicate that rads with 1-3 nodes, chemo and BMX is still of benefit. Getting another opinion on that next week.  Good luck with your decision.