IDC premenopausal positive node Oncotype score questioning chem?

4pink101

I am 43 have IDC.. Had BMX positive sentinel node ALND 6 all negative. Oncotype score 18 indicating no decrease in recurrence with chemo .. Not sure how to proceed given its been suggested by the MO as the standard of care. Anyone out there in a similar situation

Colleen73

4pink101- Curious as to what stage cancer you have?

My Oncotype is 21 and I chose Radiation and Tamoxifen due to Stage 1 grade 2

4pink101

colleen73-I am stage 2B.. 2.1cm tumor with macro met in sentinel node.. Addt 6 nodes negative. I already had a BMX and am trying to determine which treatment going forward is best??

ksusan

I wasn't oncotyped because my surgeon and MO said that if you're node+, the recommendation is for chemo.

labelle

You've written "Oncotype score 18 indicating no decrease in recurrence with chemo" If this is correct, why would you want to or be offered chemo? For what reason are any of your doctors saying you should have chemo if they are saying it will not decrease your risk of recurrence? I'd ask them why they think you need it if they don't believe it will decrease your risk of recurrence. Might it benefit you in some other way? If not, then why do it? Just because it is the "standard of care" isn't a good enough reason IMO.

Cmo65

My onco score was also 18. Because I was Stage 1, grade 1, my dr did not recommend chemo. Just rads and tamoxifen. The chemo only provide a 1% benefit to me

alf9511

I am 45 and was diagnosed in September of this year and also had er/pr positive tumor, 2.4 cm., small trace of cells in sentinel node and no trace in the other 4 nodes.  I had a BMX too.  My oncotype score is 17 and I am deciding whether or not to have chemo.  What did you ultimately decide to do?

labelle

This now seems to be a gray area. Not too long ago if you had a positive node, chemo was pretty much a given. Only in recent years are some doctors saying even with a node or two positive, if the oncotype is low, no chemo.

Both my doctors (at Vanderbilt and UT) told me no chemo with an oncotype of 11-even though I had a positive node. In my case, both my first and second opinion doctors agreed it would not help me. You might want a second opinion, as the suggested treatment seems to be swinging toward no chemo in our situations (low oncotype/one or two positive nodes).

alf9511

thanks

ThinkingPositive

does anyone know what exactly determines whether your oncotype results are going to be high or low? Is it the grade of the cancer that pushes the number up or is that the fact that you have nodes that are positive . I didn't have the test my am oh you said it would probably come back.

etnasgrl

The Oncotype test is done on women who:

1) Have Stage 1 or Stage 2 invasive breast cancer.
2) Have estrogen-receptor-positive
3) No cancer in the lymph nodes (Women who have cancer in the lymph nodes do not get the Oncotype Test.)

Your score is based on the 21 genes of your own personal tumor that can influence how likely the cancer is to grow and respond to treatment.
I had Invasive Ductal Carcinoma, Stage 1, Grade 2, clean margins and no cancer in the lymph nodes.
My Oncotype score was 27 which is in the intermediate range.
I decided NOT to do chemo. I had a lumpectomy, followed by radiation, and am now on Tamoxifen for 10 years.

Hopeful82014

Sorry, Etnasgirl, but node + women DO have their tissue Oncotyped. The test has been validated for ER+ tumors with 1-3 positive nodes.

The test hasn't been used for node + for as long as node negative but both the MOs I consulted felt it was valid. One is at a major research institute, the other heads the breast cancer research arm of her (large) institution.

Based on the predicted minimal additional benefit, I did not have chemo.

Optimist52

I had micromets in two nodes and was offered the test. My result was 22 and MO said on balance better to get on with hormone therapy as soon as possible.