Onco=18, age: early 40s

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I had an IDC 2.2 cm tumor that was removed through a lumpectomy and then clean-margined with an additional re-excision.  No node involvement, ER/PR+, Her2Neu- .Because of all of this, the MDs said I was a good candidate for the oncotype DX test which came back as a score=18/ recurrance rate=11%.  I am age 43 with no genetic history.  I have a feeling with this kind of score, the oncs. will be on the fence and will be asking me if I have a preference. I had a choice with the mast vs. lump and it was very difficult for me to make the choice.

 So any Onco 18s, what did you do?  Did your docs. suggest chemo or NOT to do chemo?  If you got minimal guidance since your score is right at the beginning of intermediate risk, what was the deciding factor for you?

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  • nash
    nash Member Posts: 2,600
    edited August 2008

    I'm an oncotype 18, was 38 at diagnosis. Stats below. Three oncs plus the surgeon said I had to do some sort of chemo--the disagreement came in how strong a regimen to do. One onc wanted TACx6, another onc and the surgeon wanted ACx4, and the third onc suggested FACx6 (5fu plus AC), which was a middle of the road chemo, and which was what I went with. After I was done with chemo, my main onc said she probably would've put me on TCx4 based on info from the San Antonion onc conference that she attended after I'd started chemo.

    I was BRCA negative, but have a very strong history of cancer, including my mom who just died of bc six months ago and my father who died of pancreatic cancer. I was told that I probably have a variation of BRCA mutation that hasn't been discovered yet.  That being said, my age and tumor size were the driving factors behind the chemo, with the gray area of oncotype 18 sort of helping to decide not to do HT only. I was told by one onc that the only way I could skip chemo was if my oncotype was very, very low.

    Good luck with your decision--I know it's a tough one.
  • oldlady
    oldlady Member Posts: 87
    edited August 2008

    Thank you for sharing your experience. I am so sorry that you have already lost both of your parents. Can you explain what all of your abbreviations in regards to the chemo treatments mean?  I want to investigate everything before I have my first appt with the onc.

  • nash
    nash Member Posts: 2,600
    edited August 2008

    TACx6=Taxol, Adriamycin, Cytoxin, six rounds, 3 weeks apart

    ACx4=Adriamycin, Cytoxin, four rounds, 3 weeks apart

    FACx6=5fu, Adriamycin, Cytoxin, six rounds, 3 weeks apart, with an extra dose of 5fu on day 8 of the cycle

    CAFx6 (which is what I ultimately ended up on after starting FACx6)=5fu, Adriamycin, Cytoxin, six rounds, 3 weeks apart, no extra dose of 5fu on day 8.

     Hope that helps. Thanks for the condolences, too.

  • jude14
    jude14 Member Posts: 293
    edited August 2008
    I had a score of 18 on the onco test and declined the chemo.  Of course now I was older 58 at the time.  I had a 1.5 cm tumor did lumpectomy with clean margins and no lymph node involvement no sign of vascular involovement.  I was er/pr positive and her2neu negative.  I did the radiation and taking the hormone pills which I hate by the way..I weighed the side effects from the chemo and decided against doing that.Undecided....My onco had suggested 4 of adriamycin and 4 of taxol but after the onco he told me he was going to tell me to take my chances and skip the chemo......

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