Debating on chemo

Debzjourney

I was diagnosed in aug had a lumpectomy in sept and reincision 10/12. I am ER+, PR+,Her- , Grade2,Stage1A and lympnode - , the main tumor was 2cm but have both IDC and DCIS. I was told on Friday that I should do chemo and then radiation, I wasn’t expecting the chemo and was prepared for radiation. I have reached back out to the Dr to see if I did a mastectomy if I would still need chemo. I was wonderingif anyone was in the same boat and what they did?

Beesie

Deb,

First, to your question about whether you would still need chemo if you had a mastectomy, the answer is "yes". Surgery, whether a lumpectomy or a mastectomy, is a localized (breast area) treatment. Chemo is a systemic (whole body) treatment and is given to address the risk that some breast cancer cells might have moved beyond the breast. So the type of surgery has no bearing on whether or not chemo is recommended.

As for chemo, do you know if this recommendation is based on your Oncotype score? That would normally be the test done to determine the metastatic risk (i.e. risk that you might develop a distant recurrence, in the body beyond the breast) and therefore the benefit of chemo, when someone has an ER+/HER2- cancer. Was it your MO (medical oncologist) who told you that chemo is recommended? Without knowing what's behind the chemo recommendation, it's impossible to comment further.

Lastly, not a big issue but an FYI. IDC and DCIS are both ductal cancers, with IDC usually developing from DCIS. So this is not really a mixed type cancer and in fact something like 80% of patients with IDC also have some DCIS. Because the IDC is the more serious condition, the staging and treatment plan is based only on the IDC. The DCIS needs to be removed but otherwise can be ignored since anything done to treat the IDC will be more than adequate for the DCIS.

Any more info you have about what's behind the chemo recommendation would be helpful.

Debzjourney

thanks for your response and info. Yes the MO was the dr who said I should have chemo. The mammoprint showed a “high risk” but I’m not sure of the Oncotype score. It says index is -0.074 I plan on calling them tomorrow to get some help understanding this. It says the average 10 yr risk of reoccurrence is 29%.

Beesie

Ah, Mammaprint is an alternative to the Oncotype test. Oncotype is used more often but some MOs prefer to use the Mammaprint index. It analyzes your cancer cells and based on the genetics of your cancer, determines the aggressiveness. A "high risk" score usually means that chemo will be recommended.

Here is some information about the Mammaprint test: https://agendia.com/mammaprint/

https://agendia.com/wp-content/uploads/2020/07/Agendia_Brochure_Booklet-VERSION-June-2020.pdf

https://www.breastcancer.org/symptoms/testing/types/mammaprint

When you talk to the doctor tomorrow, ask for a copy of the Mammaprint report. Here is a copy of a sample report: