one pos node, did you have oncotype?

Awwwwwww Suz, I see you have your results back, and though I don't have a single answer to your ?'s I just wanted to send you a hug.

Linda

I didn't have an oncotype (and wanted one) but there are some on these boards who did have one with a positive node. I know the website for oncotype was only saying for postmenopausal women who are node postive, but maybe that has changed now too?

Suz42,

I am from the October surgery thread also and I have my first meeting with the oncologists tomorrow, too.

I have wondered about the oncotype score that people refer to, but since I am ER-/PR- and her2/neu+, I don't think I get one. I will ask Onc tomorrow.

Good Luck tomorrow, I am a ball of nerves, hopefully we will both get a postive battle plan tomorrow.

Ah, now that's a good question. I bet not all. I was going through all the decision making almost two years ago now (weird to think it's been that long!) and I read all the studies and tried to get the oncologists to interact with me about how helpful chemo really would be and wasn't the big impact with my diagnosis really that it would probably shut down my ovaries and couldn't we do that in a less messy way? And I still feel that in the future we will probably be using chemo a lot less for ER+ Her2- tumors (and we will probably be able to describe the tumors with more detail, too). But one of the things I have seen over the past 2 years is that new research, is exactly that, new. And moving the general consensus of medical treatment takes time and many studies. And that sometimes, changing treatment based on the latest issue of JAMA is not really the wisest choice because another study may be in the next issue.

So, it's tough to make the decisions. And you can only go on the information you have. And most oncologists really do have more knowledge about treating cancer than I do (despite my crazy researching skills). And mostly they want to give you the best outcome they can. If you don't think that is true of your doc, get a 2nd opinion. And ask all the questions you have. And then you make the decision, based on what you know at the time, that you can live with. 

It sucks. It was such an eye opener to the practice of medicine for someone who had never been seriously ill before.

While they do the Oncotype DX test now on women with 1-3 positive nodes, there seems to be just a single study (SWOG 8814) on the impact of adding chemotherapy to Tamoxifen in node-positive women. This study on node-positive, post-menopausal women compares the effectiveness of CAF followed by Tamoxifen vs. Tamoxifen alone. That study found no advantage in CAF-T v. Tamoxifen alone for women with lower Oncotype scores.

My Oncotype score was 18, so based on the above study, I would seem to be unlikely to benefit from chemo. However, I was cautioned that it was only a single study and the study group was very small. Also I'm premenopausal so it was felt that the results might not be applicable to me. So now I'm on ACx4. This will be followed by Tamoxifen.

I had micromets in one node, my tumor was strongly ER+, my onco felt very strongly that the most critical post-surgical treatment in my case was hormone therapy. She had mixed feelings about what additional benefit chemo would have though she did recommend it given my age (44) and as the most conservative approach.  I had a very difficult time making a decision, ultimately I decided not to do chemo and she was fully supportive of that and not uncomfortable with the decision.  We did do the Oncotype DX test and it was covered by my insurance. I know that test is typically done with node-negative women but my onco felt it could also be of assistance in my case in making or further supporting my decision.  My score was a 12, that was helpful to know.  The hardest thing was making a decision, once made, I just moved on.  I know most women in my situation would have probably done the chemo, for some reason it just did not seem like the right choice for me.  Only time will tell if the right decisions were made - for now I am 6 months into tamoxifen, living my life and feeling great!

Best wishes to all,

Julie

I had micromets in one node and struggled over the decision to have chemo. My micromets weren't discovered in the initial tests during surgery, but only after the final pathology was complete.  This shocked everyone as I had a low KI-67 score and a tumor < 1cm. I really had a hard time with the chemo decision.  Since I was premenopausal the Oncotype test was not recommended.  My onc recommended chemo, but said it was my decision. I finally told him, "I've tried and tried but can't convince myself not to do chemo ... Let's go for it.   I had 4 rounds of TC that put me into menopause after the 1st treatment.

The cheno was not bad ... but I too question.  Did it do me any good?  I'm on Tamox now and have just had the metabolization test to determine if I'l stay on Tamox or move to an AI.  So far so good!