Oncotype Dx for Node Positive

2»

Comments

  • Seabee
    Seabee Member Posts: 557
    edited January 2009

    Matic--I appreciate your concern for me and your taking the time to write this thoughtful post.

    I know that Adriamycin is a potent anti-cancer drug and that it is effective against some tumors. I have come across several studies that found it ineffective against lobular. One of the most detailed of these is a German trial of the effect of neoadjuvant chemotherapy on breast conservation surgery.  Whereas ductal tumors had a pCR of 12.8%, lobular tumors had a pCR of only 4.8 %. See http://www.annalssurgicaloncology.org/cgi/content/full/13/11/1434?ck=nck. In other studies the response rate was even lower, i.e. 1%. So some ILC respond to anthracyclines, but most don't. This may be partly due to most of ILC being HER2 negative, but some negatives do respond to Adriamycin.

    I know the study of TC versus AC is not definitive as to which is superior (if either). Another study is in progress which supposedly will answer this question.  But TC is now being widely used instead of AC because of the cardiotoxic potential of Adriamycin, which is my main objection to it. The small chance of benefiting from Adriamycin doesn't seem to me worth taking if there is even a small cardiac risk.

    According to what I've read, in terms of overall survival,lobular tends to do as well as, or slightly better than, tumor types which respond better to chemo. So it must have properties which we don't know about yet that produce these effects. Of course there are always exceptions. As I see it, nothing is guaranteed in this game, including chemo and Oncotype DX prognosis.

  • Fleurdesel
    Fleurdesel Member Posts: 1
    edited February 2011
    I am 48 years old, pre-menopause, tumor size of 2.3 cm, ER/PR +++, Her2 new negative, growth rate 1-2, classified as Stage 2 but found with 1 lymph node positive (sentinel). I went back to surgery to analyze axillary lymph nodes and 7 out of 7 were found negative. It seems that a couple of years ago, I would go straight to chemotherapy because of one lymphnode positive. However, according to my oncologist,  Oncotype Dx has been lately validated for women with up to 3/4 positive lymphnodes. As a result, a sample was sent to Genomic Health land I am now waiting for the oncotype Dx results before making then decision to go or not to chemotherapy.
    I read the 2 papers I found related to this topic. It seems that the test is validated for post-menopausal women only and I am a little bit worried. If the Oncotype Dx results show a low risk of recurrence, how comfortable would you to not going to chemo knowing I am pre-menpausal?
  • IllinoisNancy
    IllinoisNancy Member Posts: 722
    edited February 2011

    Hi Seebee,

    I am proof positive that AC gets rid of ILC.  I was dx with a recurrence in October and they could see four small tumors on the skin of my left breast.  After just one treatment, they dissappeared.  I have completed all of my AC and now moving on to Taxotere, I have 2 left, and my breast shows no sign of cancer.  I'm getting a BMX in April anyway because I don't want it to ever come back.  I used to believe the articles about chemo not helping ILC but I am a believer now that it works great!!

    Take care,

    Nancy

Categories