Chemo confusion

Bookwormgurl

This is my first time posting and I am confused. I had unilateral mastectomy for a 1.2 cm idc and asmall dcis at the beginning of February and during surgery they found two positive (macro mats) lymph nodes. I was told after surgery I would likely need chemo but I am so confused because I have er+, her2-, low ki-67 (<10) and my oncotype score came back at an 8. One oncologist said he would recommend TC chemo and the second opinion oncologist I saw yesterday said she would do dose dense A-CT. it Did anyone with similar scores do dose dense A-CT? It seems like most people in this group that have similar scores etc do the tc, so I was a bit surprised to hear A-CT was recommended by the second oncologist. Her main Reason was that it had gone to the lymph nodes and it was standard of care.. I am trying to wrap my head around everything but it just seemed so different from what I have read on here and other places. Any thoughts would be appreciated. thanks

keepthefaith

I'm not in a similar situation, but the Dr's look at many aspects of your diagnosis. The Onco-score is just one piece of the puzzle. It's great that you are getting more than one opinion. You didn't mention the grade of the tumor. Higher grades respond better to chemo than lower grades. Hopefully someone with more knowledge will chime in with more information. Ultimately, it is your decision to make. Best wishes!

Bookwormgurl

keepthefaith - thank you for responding. That is a good point. My grade is a grade 2, so maybe that is part of what played a part in her recommendation for A-CT.

LeesaD

Post mastectomy pathology showed two sentinal nodes with micromets. My MO ordered Oncotype. I had ALND prior to Oncotype results coming back. The ALND pathology showed 2 of 14. more nodes fully positive. My MO set me up for AC-T chemo. After port placement my Oncotype results came back and result was a score of 3. My MO encouraged by the low score changed the chemo to TC. He said the heart risk from the Adriamyacin outweighed what he thought would be any benefit now with such a low score. He presented the case to the tumor board and they all agreed on the TC since there were 4 involved nodes even though two with just micromets. My tumor grade 2 also.

Moderators

Hi Bookwormgurl, and welcome to Breastcancer.org,

We're so sorry for the reasons that bring you here, but we're really glad you've found us. As you can already see, our Community is full of amazing members, always willing to offer information, advice, and support.

We also wanted to share this page from the main Breastcancer.org site, that you may find helpful: Choosing a Chemotherapy Combination. There's also some good advice on questions to ask your doctors about the regimen they are suggesting on the Talking to Your Doctor About Chemotherapy page.

We hope this helps and we look forward to hearing more from you soon!

--The Mods

InnaB2018

I had one node with a 7 mm macromet. Grade 3 tumor. I had DD AC-T because of it. My doctor didn’t even send for the Oncotype test. She said it’s not a standard of care. If have a positive node, i’ve Got to have chemo. And because of grade 3, I got the strong one.

Runrcrb

talk to your oncologist and feel free to get a second or third opinion. As someone noted the ultimate decision is yours. I have always felt that I needed to be comfortable and confident in the plan, whatever that plan was, in order to sleep at night and feel I’d done what was necessary to beat cancer.

Bookwormgurl

thanks everyone. I think I am starting to wrap my head around chemo just need to decide which one. In the meantime I’m waiting for some other test results

MexicoHeather

I think my treatment was based on the grade. One of the cancerous lymph nodes was rather large, too.