Is this my final answer?

Cookie - I so know the flip flopping.  It's awful!

You have done very thorough research - amazing research.  There just is no great answer for those of us in the middle.  As thankful as I am for the oncotype with the attempt at personalizing treatment, the dreaded intermediate zone bites.

I applaud your choice, and you do not need me to wish you luck, but I will!

Im proud of you, and your decision.

You sound like me -- research like hell and flip-flop a thousand times... drives my Type A driver-driver husband crazy!

In the end, you gotta go with your gut - and don't look back!  

I don't know your whole story, or diagnosis, so I can't weigh in on whether or not you should have chemo, but one thing that helped me when I was in the decision making phase, was the person who said, "You have to make the decision based on what you know right now. There may very well be a research study that will give you different information in another 6 month or year, but you have to decide now. So make the best decision you can and they move ahead." It helped a lot, because 2 years ago I couldn't get an oncotype with a postive node, yet I KNEW they were moving in that direction and I just wanted that one more piece of information sooooo badly.

You know what you can know at this point in time. No one can ever say you made the decision lightly! And if things change in the future, well, they change. You have to live in the now. 

I just wanted to thank you again for the discussion over whether or not to do chemo. It helped me to focus my thoughts in making my own decision. Today I had the appointment with my ONC and I decided --  it's only four months, I'm healthy, so yes I'll do it. There really isn't yet enough information known about the benefits of chemo for women with ILC or for women of my age group, 65 and older, in threshold cases,  with or without an RS to go by.

My first chemo session is Fri Dec 18th. 

Kathy, doesn't it feel good to crystallize your thoughts and move forward? Good luck with the chemo. Wishing you minimal side effects...

cookiegal:  how was your meeting? Been thinking about you... and wishing you well, no matter where the journey takes you next!

My onc said if the benefit was 4% or less, chemo should be off the table.

with standard chemo, I would have gotten 3.5-4% benefit; he said the main reason Europe was doing so much chemo is to kill the ovaries.

Perhaps if you speak to the ovary situation, it may crystalize your decision.

Lupron (if you are still pre-meno) and if you are ER/PR positive, a hormonal.....

My onc said most of the benefit was in killing off the ovaries with chemo but I am so close to menopause (not sure if I am in it or not...no periods since tamoxifen to speak of).

I still wonder if my decision was correct (my onco score was 20) but can't look back now.

There will always be someone who showed doing chemo helped, someone who did no chemo had no reccurence, and the opposite.....

Best to you!

wallycat: "killing off the ovaries?| very confused by that remark and the slur about Europe.  What did he mean?  Chemo kills cancer cells, and is highly effective in post menopausal women without active ovaries - it really depends on the patient, cancer profile etc.   Maybe I'm misunderstanding something.

 Cookiegal:  Glad you made your decision and feel at peace!

Luah, there are some oncologists who think that the primary benefit of chemotherapy for ER+ premenopausal patients is that it often shuts down the ovaries. I was under the impression that in Europe less chemo is used because they use other methods of ovarian ablation -- surgery, lupron, radiation. Someone from Europe (a large place so I imagine there is variation!) chime in. Under the St. Galleon guidelines (which are European) it was not clear that I would need chemo. Under the NCCN guidelines I was a definite yes for chemo.