Seeking Advice - Chemo or no?

jdubbs1

Hi Everyone!

I am posting on behalf of my mom. We are currently trying to figure out whether or not to do chemo and are at a loss and seeking some advice on what to do! She is 62 years old and post-menopause and has stage IIB IDC. Tumor was 2.3 cm, grade 2 and she had 2 nodes taken in her sentinel node biopsy. 1 was positive with a macromet at just above the threshold to be positive (0.21) and one was just below as a micromet (0.18). They did not go back to do an ALND because they are going to treat her nodes with rads, so we don't know if she has additional positive nodes. We were set on doing chemo but her surgeon ordered an Oncotype test which came back extremely low at 4. Per her Oncotype test, she has a 10% recurrence risk with Tamoxifen + chemo and a 7% recurrence risk with Tamoxifen alone. My mom is now doubting whether or not she should do chemo because the Oncotype is telling her she has a 3% greater risk of it coming back by doing it! I'm not sold on the Oncotype because they didn't go back to get more nodes (so how do we know she really only has 2 positive) and the SWOG study treated with CAF chemo and they are suggesting T/C x 4 for her. Has anyone else been in a similar situation? Did you go for the chemo despite the Oncotype saying you'd be worse off just to throw everything you could at it?

Post edited to say that she had a lumpectomy and will do radiation and hormone therapy, we are just trying to figure out chemo! She is highly ER/PR positive and HER2-.

Thanks to all and sending lots of love to everyone on this board!

Meow13

No my oncodx test came back 34, but I didn't have positive nodes. I was 53 and chose no chemo. However, a coworker diagnosed within 6 months of me had 1 small tumor ILC near the chest wall no nodes and had an oncodx score of 4. She didn't do chemo however before the year was out it was discovered in her hip, bone mets. She seems to think that met may have been there at the time of diagnosis. Not sure chemo would have changed her outcome. She had radiation to the bone for treatment.

The oncodx is a statistical tool it can't tell you will or won't get a recurrence. Your mother has IDC not lobular since she is hormone positive then hormone treatment might actually work better. Because the oncodx score also gives you an idea of how well chemo will work. Remember that hormone therapy is a systemic treatment as chemo is.

My coworker had a lumpectomy and savi radiation and hormone therapy tamoxifen. I had a mastectomy, no radiation and anastrozole AI hormone therapy, I had 1 ILC tumor 1 IDC tumor no recurrence 7 years out.

keepthefaith

jd, If you haven't consulted with a Medical Oncologist, pls do so. The BS specializes in surgery, not treatment. If you have already seen an MO, go see another one, for a second opinion, if you need to. You didn't really say whether chemo was recommended, or just assumed. I don't think you should base the entire decision of chemo, on an Onco-score, but it is definitely an important piece of the puzzle. 4 is a very low score. You don't want to make a knee-jerk decision based mainly on fear. Best wishes to you both!