To chemo or not to chemo: Conflicting test results

hakunamatata

I have a question about conflicting test results. I am 44 with 2 small kids. I was DXd with stage 1 ILC, 1.7cm grade 2 tumor, HR+/HER-, no lymph node involvement (exactly what was studied in the TailoRx study). I had a DMX on May 31st with clear margins. My Oncotype score came back low risk at 15. With this result, chemo would most likely not be necessary. Since it was borerline for women under 50, my MO and I decided to do additional testing with Mammaprint for validation. However, it came back as high risk. Now the decision is ultimately mine on if I should do chemo or not. I know and was encouraged by what the latest studies show, but the conflicting results give me pause. Which results should I put more stock in and what additional info should I consider? Has anyone seen this before? Thanks!

moth

Wow, tough choice. I guess in the next few years we'll have more cases like yours with discordant results of genomic testing. I'm guessing eventually they'll figure out the discrepancies but it doesn't help you now at all.

Have you tried running your numbers in the old large probability calculators like Predict http://www.predict.nhs.uk/predict_v2.1/tool

or Lifemath? http://www.lifemath.net/cancer/breastcancer/therap...

I think given that you're so young, I'd lean to the extra bit of protection from chemo but of course, it's not without its risks too. How stressful it must be to make this decision. Maybe consider getting another opinion from a second MO and then whatever you decide, don't look back & second guess yourself...

best wishes ~

Georgia1

Hi there. To answer your question, tough call but in general the Oncotype DX test has more research behind it than the Mammaprint. But I agree with Moth that you should ideally find an MO at a different hospital, ask a lot of questions and get a second opinion. All best wishes.

Denise-G

I would definitely get a second opinion to help guide you and your decision from an NCI Designated Cancer Center

https://www.cancer.gov/research/nci-role/cancer-ce...