Breast Cancers that Disappear Without Treatment?
Comments
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Dierdre, because you don't have your cancer and stats on your signature line, I didn't realize you had DCIS. DCIS is hard to pick up on mammo except by microcalcifications which often go ignored or are put into a wait-and-see mode. That is one part of breast cancer, not the whole thing. DCIS is not something that can usually be picked up by self-exam either. I can see where you are coming from in so many ways now.
Full tumors are usually picked up on mammos. But as has been said, it is really the reader of the films that has our lives in their hands!
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Re: Chemo effectiveness in highly er+/pr+ BC.
I forgot about this earlier post from the hormonal therapy forum. Here is evidence that chemo does improve the outcome in node negative er+/pr+ early breast cancer. It looks like it improves long term DFS by absolute 9.5% over tamoxifen alone.
The link doesn't work. PM me if you would like a copy of the article.
From: "Hazard of recurrence and adjuvant treatment effects over time in lymph node-negative breast cancer" J.Dignam in Breast Cancer Research and Treatment
Twelve-years recurrence-free survival percentages are 70.2% for surgery only, 80.9% for tamoxifen, 86.3% for tamoxifen plus MF, and 89.4% for tamoxifen plus CMF.
Please consider your long-term health when making your decision regarding tamoxifen
http://www.springerlink.com/content/j67g354260312261/fulltext.html
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greenfrog, you wrote:
".........On another topic I am surprised by how many people invest in the OncotypeDX test. The whole area of genomic assay is still very much in development and OncotypeDX in particular does not factor in the crucial advances made with aromatase inhibitors - it only runs comparisons with Tamoxifen. It has been rejected (in its current guise) by almost every country except the US ........."
I had no idea the OncotypeDX had been rejected by almost every country except for the US. I am disappointed, but not at all surprised by this information, considering the current sorry shape of the whole medical system in this country.
Thank you for this information.
Do you have the supportive documents on that subject? I would very much like to share with others.
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The OncotypeDX is patented to a company in the states and they have a weird priority ranking that has made it not very effective for "outsiders" (me) to use. The cost for us is prohibitive if I understand from other posters. Too bad for those needing Tamoxifen.
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Yazmin - I have seen Taxotere work remarkably well when used pre-adjuvantly with a large ER+ tumour. It obliterated the breast tumour completely - it disappeared to nothing. I have also seen FEC fail completely in a pre-adjuvant setting.
OncotypeDX is rejected by the UK National Health Service simply because it is still experimental. There isn't the data to completely support its use. It appears to be a very effective instrument but appearances can be deceptive! TAILORx trial is still many years away from coming up with any kind of definitive results. As of summer last year they were still only at enrollment stage and anticipated 2 more years of that.
Cancer is very big business - http://www.nytimes.com/2006/04/13/business/13diagnose.html?_r=1&pagewanted=1
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Interesting that UK has rejected the Oncotype DX. My original oncologist in the US refused to order it for me unless I agreed to be in the TAILORx study and not be allowed to know the results of my tests - just enrolled in the randomized trial. He said that he would not order it because he did not believe in it. I personally didn't like his general demeanor as well as feeling like I was his person lab rat so I switched oncs.
I had a small tumor at 1cm, highly estrogen sensitive and the most recent information indicated that chemo wasn't going to do a lot for me anyway. My Oncotype DX score also came back low so I went with the multi-confirming data.
I believe it is just another way of researching what is available (if it is available) and making as informed of a decision is possible with all of this mess
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Barbe...Genetech will help with the payments of the Oncotype DX test if you cannot afford it.......It is Not strictly for US patients only....Please visit OncotypeDX website......They have a toll free number there that will help....
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I had "diagnostic" mammograms AND ultrasounds every 6 months for the past 5 years, they didn't catch my BC, it was ONLY after the radiologist ASSISTANT saw something she thought looked different was it suggested by her not the radiologist (who said all was well see you in 6 months) did I get an MRI with contrast which found the tumor and I had the biopsy etc etc. I am sorry to say but my confidence in mammograms has diminished. Also I am from England and before I moved over here my experience with the National Health System was always very positive.
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It is interesting to get the perspective on the onc test from those of you outside the US. My onc was all for me getting one, as long as I would sign up for the arimidex trial. They were wanting me to wait 2-3 weeks for the results of the onc test to decide on chemo and rads. I just wanted to get it all over with. When I told them I was thinking about not taking arimedex, I had constant arguments with the nurses to the point I was fuming everytime I left the onc. They said they would not sign for my insurance to do the test, unless I was in the study. I said forget it all. The onc had said I probably would not need chemo, and I did not want them to change their minds because of this test. I just wanted to start rads and get it over with. I am so glad I listened to my gut telling me not to go this route, especially now that you are saying it is not accurate. This test would have cost me over $1000. Another example of someone making a lot of money here in the US because of the big business of cancer. I really do not want to see nationalized health care because it will be a bureacratic nightmare, like everything else the government runs, but at least it does force health care givers to be fiscally responsible.
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It's not that I can't afford it, but there are ladies from Canada who have paid for the test and are still waiting 6 months later. Their samples keep getting bumped by US customers. They needed to make decisions sooner than that....
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greenfrog, you wrote:
I have seen Taxotere work remarkably well when used pre-adjuvantly with a large ER+ tumour. It obliterated the breast tumour completely -
Thank you for your response to my question. However, you are aware of the fact that shrinking tumors has NOTHING to do with survival, right? In other words, yes, I knew that Taxotere (and other agents) shink tumors dramatically. But I am unimpressed, because that does not improve survival. Alas.....
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