Should I expect chemo?

Mary Lynn, I have the same diagnosis. I got biopsy results 2/11/08. I had a bilateral mastectomy (my request) on 3/26/08. I met my oncologist before my surgery and was reassured. I asked my oncologist about an oncotype test and she requested it. It made my choices much more clear. I opted to do the 4 rounds of chemo (TC) that my oncologist recommended.

I am 65, very good health, post menopausal. I am also taking Femara (AI) daily and infusions of Aredia (to strengthen bones) every 3 weeks.

My 1st chemo was 5/24/08. On 5/26/08 I got very nauseous and i think I threw up my toenails. My onc gave me medicine that stopped that immediately. He also said it would not happen again since he now knows exactly what I need to avoid that. We shall see! Tx #2 is 6/13/08.

Oh, I have a husband/wife oncology team.

One more comment. My tumor was .9 cm, originally thought to be 1.6cm or 1.9cm. 10 nodes removed - all negative. Surgical pathology report ER+ PR- HER2 -/+?.

 The oncotype report gave much clearer results - and different - ER+ PR+ HER2-. It also made clear what the statistics were for recurrence with or without chemo. My onc said it was my call.

I decided to drop my chances of having a recurrence as low as possible. I have not regretted any of my decisions - yet.

ACS standards are chemo for over 1cm, no nodes, ER/PR+, Her-

I was over 1cm, but grade 1, stage 1, and post-menopausal, so my doctors didn't recommend.  

The determining factor is often whether or not you have been through menopause, and also whether you have other medical conditions that make chemo problematic.

Oncotype numbers can help, but don't forget that many of our oncologists have 20 or more years experience with this, and we shouldn't ignore that knowlege.

Both the oncologists I consulted are considered among the best in our area, and they both agreed. 

Sue

Hi Lynn, I was diagnosed Aug 07, had right mastectomy with expander, had them exchanged for implants in March, It was 1.7cm, stage 1, grade 1, perimenopausal, er/pr+, her-, no nodes. My onkotype dx score was 12. I chose not to do chemo. I am on tamoxifen. So far so good. good luck with your decision. Before the onko test my oncologist suggested chemo because of my age but when the score came back 12 I chose not to do it and he felt okay with this.

My oncotype score was 17 - right on borderline. The oncotype report said my chance of recurrence was at 11%. My onc said if I did TC 4tx it would drop those numbers to 7 - 8%, then with taking femara daily and aredia every 6 weeks, my chances of recurrence would drop to 4 - 5%. This would put my chances back to the same as someone who has never had cancer. That sounded good to me. She also told me if I wanted to stop at any time I could.

If my general health were not as good as it is, or if I were getting worse SE's from the femara or aredia, I probably would have had a much harder decision.

Hi Lynn - I would encourage you to ask about Oncotype DX - may help with your decision. My diagnosis is similar to yours - except mine was a grade 3. Oncotype DX came back at 28 - the decision was made for me - needed four rounds of TC. Finished almost 3 weeks ago and now going on to radiation. I am 54.

Deb

Good news grade 1 stage 1. I had both and had the oncotype which came back in the low catagory (8) so no chemo for me just radiation. I am having a oophorectomy next week. I am 45 I was diagnosed in 2005. Stacey

2/24/2010

Hi-

I realize that the last post was from 2008...here's my story and experience with Onco (Genomic Health)

I was diagnosed at 30 on Dec 3, 2009 - IDC, 1.3cm, no nodes, ER+/PR+, HER2-, BRCA -, I opted for a dbl mast with tissue expander reconstruction (very pleased)- I too thought that since no nodes were involved that my surgical decision was to rid all that could have been infected, that it would create a slim to none chance for chemo- oh and I'm getting married 5/10...great timing!

So my doc and I do the Onco DX- my score came as 31!!  My doc noticed something not right, I met with a oncologist (before knowing my results were in)- my doc had called the oncoligist- to let him know that something was fishy...so I met with the Onco, and he sees 31, and immediately tells me about the most aggressive treatment...upon leaving, I ask for copies and Oops, all of a suddden, he tells me that the ONCO test was based on an ER Neg- not ER+, which is conclusive by 3 tests...he would never have mentioned it to me if I didnt ask for copies...then he was suppose to send out a new speciman to Genomic (he leaves for vaca), turns out he sent the speciman back to the hospital that I had surgery- so It's now been sitting there for  week, when my doc and I thought he sent it to CA...so 3 weeks after my ER+ speciman was to be sent out- the lab is giving me a hard time for a repeat test!  Now. IF this redo (if they redo) comes high again, my window for fertility and chemo are closing in - I have been back and forth trying to get an explaination as to WHY the lab is on the brinks about not retesting- when my health is lying on it...so hopefully I will recieve some answers today-

Moral to my story is: Triple check everything and make sure you receive copies of everything in every doctors medical chart- I have everything down to the actual surgical notes

keeping my fingers crossed that they redo and score comes back LOW...

 Take care- best wishes to all!!

A

I see that most of the posts on here are pretty old, but this seems to be the closest section to what I'm dealing with.  I am 37 and premenopausal; 4 weeks ago I had a unilateral mastectomy. (Got an implant at that time and reduction on the other side.)  The path report on the tumor came back as 3.3 cm, IDC, Stage II, ER+/PR+, HER2 equiv., node neg.  I am currently awaiting results on the Oncotype test, and have a PET scan scheduled for next week.  I have been super positive and "calm" since my diagnosis but now I'm starting to get worried. I hate waiting; I like to have a plan, and something to work towards.  This might sound dumb, but I'm almost afraid of my gene test coming back with me in the low risk category because then they might not recommend chemo, and I just feel like with my age and it being stage II, it might be best to have chemo.   What do you guys think?

btw, best of luck, A., with getting your test re-done, and getting good results! And with your wedding!!  That is so exciting!

Thanks Michele, I feel better hearing that your feelings are similar to mine; and what you said about the oncogene test.  I completely agree with what you said about not liking the SE of chemo but wanting to throw everything at the disease.

I really hope your liver lesions are not a big deal.  Do they have to biopsy those, or just monitor them with scans after your chemo?  How many treatments are you having and how frequently?  

I am wondering if any of you who have commented on this thread are still loging on and participating? I'm a new member here as of today. I had recent bilateral mastectomy with skin saving repair on 4/7/11 and am meeting with my oncologist for first time on 4/19/11. I had a 1.13cm invasive ductal carcinoma tumor, stage one, negative sentinel node biopsy (3 sentinel nodes taken, all neg), Er +, Pr+, Her2- tumor. I'm 52 and premenopausal. My surgeon indicated this wk that with my age i should see the oncologist and she will most likely ask for the oncotype test to help decide about chemo options. I read all of your posts, found them very interesting and helpful, and am wondering how you all are. This is the first online chat discussion I've ever done so I'm really new to all of this as well as breast cancer! I have done quite a bit of reading re breast cancer. I was diagnosed 2/25/11 so had five weeks to research prior to surgery. I have a background in medical

social work (17 years), and was able to choose excellent surgeons from our area. So far my recovery has gone well. Now learning now about what is next. Pls let me know how you are doing!!

To Jan508



What is a mammaprint? Have not heard that term yet.



Thanks

Sherry