Any 65s that had to have chemo?

mudd

I just found out I have a high Oncotype and need chemo. Still in shock and can't stop crying. I also posted under the Chemotherapy thread. Anyone out there my age (65) that underwent chemo? I don't understand why I need it since I had a BMX with no node involvement but just the high Onco. score. I don't know what to do

Meow13

Hi Mudd, I went through what you are experiencing but I was 53 at the time and my score was 34. I wrote on your other thread. You don't have to do anything if you don't want to. You are taking anti hormone therapy that should help protect you.

I did a single mastectomy and had no nodes. Once you talk to your mo you will feel better. I don't place that much on the oncodx score but my mo did. My risk of recurrence is 23% with tamoxifen but I was doing AI drugs at the most my risk could have been reduced by 11% not overwhelming to me. It is a guessing game. If you do chemo it doesn't mean the cancer won't come back.

Now, I know you are 65 I think again about skipping chemo. But it is up to you.

Rgmcmanus

Hi Mudd! I will be 65 in February. I was diagnosis with bc in May of last year and had a lumpectomy with interoperative radiation. I had stage 1A ductal carcinoma that was er positive and her-2 negative. Also the node was negative. I thought everything was great and would be on hormone therapy for 5 years and done. But I was blindsided by the oncologist when he told me my onco dx score was high and I needed 5 months of chemotherapy. My score was a 26. Ugh why 26!!!! After crying all the way home, I looked at the test results again and I thought 1 point!!! I have a 85% chance of it not returning and 15% of it returning. Chemo would lower it to 5%. I made the decision not to do chemo and met with the oncologist again to see if there was something else we could do but he was adamant that I should do this. I left undecided but not convinced. I met with the breast surgeon again and I could tell she wasn’t happy with my decision. She said my results were like 26 out of 100 that the cancer would return but it would not be curable. Ugh! I am a nervous wreck! Have I signed my death warrant😔 I completely know how you feel! The quality of life for the next 2 years and to fight something that might be there is unimaginable.

MinusTwo

I had a BMX at 67 and recurrence with chemo & rads at 69 & 70. Look for the chemo threads that are usually started every month so you can get feedback from people in active treatment.

Beesie

Rgmcmanus,

Did you receive a copy of your Oncotype report? For someone over age 50, a 26 score is in the grey zone. It is not an automatic chemo recommendation. And the figures you received (15% risk without chemo, 5% risk with chemo) seem way off. A recent very large study only compared hormone therapy alone vs. chemo + hormone therapy for patients who had scores of 25 and lower, but at a 25 score, there was found to be no difference in recurrence risk at all. So it's impossble that there could be a 10% reduction in risk from chemo at a score that is just one point higher.

The NCCN treatment guidelines are the gold standard used by most doctors in the U.S.. Here are their breast cancer treatment guidelines for patients: https://www.nccn.org/patients/guidelines/content/PDF/breast-invasive-patient.pdf

And here is a screenshot of the page covering chemo recommendations. I have circled in red where you fit, with your diagnosis:

There is also a physician's version of the guidelines, with more detail. You can see that up to a score of 25, chemo is not recommended. For scores of 26 to 30, the treatment options are either hormone (endocrine) therapy alone or chemo followed by hormone therapy.

I'd suggest you talk to another oncologist to get a second opinion. Unless there is some other reason why you are high risk,I doubt that most oncologists would recommend chemo to someone who is 64 with a 26 Oncotype score.

Beesie

Here is a chart from the Appendix of the study I referenced, which was called the TAILORx study.

https://www.nejm.org/doi/suppl/10.1056/NEJMoa1804710/suppl_file/nejmoa1804710_appendix.pdf

The 9 year metastatic recurrence risk for a 26 Oncotype score for a patient over age 50 appears to be approx. 7%.

Cowgirl13

I had it when I was 63 and didn't have a lot of side effects although you sure do feel it. My oncologist has a very good protocol for dealing with side effects.

mudd

Rgmcmanus Hope you are all doing well. I opted for chemo back in Dec. 2017 (wow , seems llike both a long and short time ago!) and had four rounds of TC. I found the neulasta to be the worst of it. My doctor didn't really give me much of a choice since I had a high onco score and now I'm glad I went through with it so I know I did everything possible. Still freak out everytime I get a little twinge or ache. Best wishes

Rgmcmanus

Hey Bessie! I could kiss you right now! I studied all the information that you provided and even research a lot more. I wanted to be prepared when I went to my 6 month check up with my surgeon. Well it was today and it when really well. We visited for a long time and after the exam, I asked her to run my RSPC score and she said yes, I'll do it while you get dressed. My RS score sheet showed I had a 16% recurrence rate. She came in and sat down with me and showed me the RSPC score and my recurrence rate is now 6%!!!!!!!!! She even said I think you made the right decision! If you hadn't posted about this score, I would have probably had a mental breakdown worrying about my decision. The knowledge that you have passed on to us is remarkable! You are an angel! I just wanted to thank you for caring enough to help women who are going through this difficult time.

Beesie

Just replied to your other post. Doing the happy dance for you!!