Oncotype dx

Hi Sereena, I had the Onco done, but I am node negative.  Honestly, since you are asking advice, I would have chemo if I had cancer in my lymph nodes or if I had vascular invasion. Both are the two greatest ways for cancer to spread.  Good luck on your decision. If you are unsure, you can also seek a few opinions and have severla Oncologists give you a recommendation.

Sereena,

 I had 2 large positive nodes and an oncotype of 12 which is low. I saw 3 oncologists and all 3 recommended chemotherapy but I was premenapausal. I agree with the others that you should seek a second opinion.

Your going through the hardest part now, coming up with a plan. Hopefully, one that you're comfortable with!

By all means, get several opinions.  And remember, that the Oncotype DX test is just one tool in helping make the decision whether or not to do chemotherapy.  If you wish to exclude the information derived from the Oncotype DX test in making your ultimate decision, then that's okay. 

Personally, I think you need all the information possible to make a decision AND you should get several opinions.  Remember, grade 1 breast cancers USUALLY do not respond as well to Chemotherapy as grade 3 breast cancers.  But since you do have lymph node invasion, that, obviously is a concern.  I think what your physician did, by requesting the Oncotype DX test is the prudent thing to do.  I think s/he's in the gathering of information mode.  The more information you have, the better position you will be in when it comes time for treatment decisions.

Lastly, once you gather your information, check out the 2011 NCCN Guidelines for your type of breast cancer.  The NCCN Guidelines provide standard of care.

Good luck.  My thoughts and prayers are with you.

Sereena ~ I'm with voraciousreader on getting a second opinion.  What jumped out at me about your dx is that you had a relatively small lesion that was classified as Grade 1 -- yet you had 3 positive nodes, which seems to indicate that something isn't quite adding up, because there is some aggressive component to a bc that is that small, but in 3 nodes.  You might also want to get a second opinion on your pathology. 

Your above post didn't indicate if you had a lump or a mast, and I didn't take the time to read back through your earlier posts, but that might also factor into how I would look at your situation.   Deanna   

What were your levels on the onotype test for your ER and PR levels.   My ER was somewhat high but my PR was below average.  I factored that into my decision since the higher they are the better the hormonal therapy works.  I agree with the people who say a grade 1 does not get much benefit from the chemotherapy and that needs to be considered.  I had a 27 oncotype and was a grade 3 but did not have any cancer in my nodes.  I did TC x 4 but my oncologist gave me the choice about having chemo since I was still in grey area.  Good luck!    I am glad I had the chemo yet struggled with low energy for a long time afterwards, lost my eyebrows for good and toenails are terrible to look at and make some shoes uncomfortable to wear.  Still all in all if it keeps cancer away it was worth it...I will never know since the arimidex could be keeping me in the safe zone and not the chemo and if it comes back who will know if I had the best chemo for my cancer or if it might have delayed it etc etc.  It is all a guess and has a great deal of uncertainity no matter what you choose.

Hi

I think I would be concerned about those nodes.  I had a 27 on the oncotype, no node involvement and I chose 4 rounds of A/C (I was at the Farber as well).... have never regretted it.... it was hard, but I am glad I did it...... I  know your score is low, but think about those 3 nodes..... can you get a second opinion?  

Sereena--I think you've made a rational choice.  Nodes tend to be overestimated as a prognostic factor, especially if the involved nodes are sentinels. Lobular tumors are typically slow-growing, so it might have taken years for three stray cells to be trapped by the three nodes closest to the  source. First there was just one, which developed into the larger mass. Later, when the tumor got bigger, two more stray cells were trapped.Given the time lapse between the larger mass and the smaller ones, that doesn't seem terribly aggressive to me.

A/Is can cause side effects, but don't be afraid to try them. There are other options besides Arimidex, and there are ways of managing the side effects they do cause. Most people have no serious ses. I take Femara, and have had nothing except fatigue, which I got rid of by taking a month's vacation from the pill with my oncologist's blessing.

Hi Sereena, I am late to this conversation. But my wife has to make a similiar decision on chemo or not.1.3 tumor Lumpectomy, Radiation nodes all clear. Oncotype was 20. She really wants to avoid chemo, Oncologist says it her decision but recomends it. Might help, might hurt.I guess what I really want to know is how are you today?