Curious, if your Oncotype was intermediate..

I had an Oncotype score of 24.  My MO gave me the choice of chemo or not, but seemed to be pushing for chemo.  In any case, I did AC x 4.  Not bad.  No ill-effects long-term.  The chemo was to give me a 3% improvement in survival.  (I'm now at 9%).  I also had a bilat mastectomy and am on Arimidex (generic).  I wanted to be as aggressive as possible.  Nothing is worse (in my opinion, for me) than a recurrance and chance of mets.

My test score came back in the middle and my onocolgist would not recommend one way or the other whether to have chemo or not.  I have to meet with my doctor tomorrow to give her my decision. I am struggling with this. If the doctors and the study cannot show if there is a benefit to do the chemo then it is very hard to say just go ahead and do it with all of the side effects that it has.  The short term ones like hair loss and fatigue are not the big concerns but what it could do to my heart, kidneys and lungs if the chemo is not necessary.

I'm just getting home from the oncologist. My oncotype came back as a 19, the lowest range of intermediate.  He said it would lower my risk by 3-4 percent if I were to have chemo.  I really don't want it. As far as recommendation, he said he could understand and live with my choice; he'd put his recommendation as 60-40...60% in favor of chemo, 40 percent not.  Big factors for him were the size of the mass, and the clean nodes.  So, am I doing the right thing by deciding against chemo? Who knows?

I was intermediate as well with a 14% chance of recurrence.  I initially decided to do chemo and began CMF which wasn't so bad.  I had seen four oncs and got:  do it, absolutely don't do it, 50/50 and 60/40.  I kept reading as I went through CMF and came across the NCCN guidelines which were consistent with what Peggy said above.  Check them out to see what they are saying for you and be sure to check the footnotes carefully.  Mine were on page 16 and stated that I was unlikely to get benefit from chemo and both my med onc and rad onc agreed. I completed five of twelve infusions before stopping without regret.

The Ki-67 is another measurement, sometimes referred to as the poor man's oncotype.  However, my docs have some faith in it - it refers to mitotic growth rate.  Like Sherry, mine was less than 10% and I made my decision to stop the chemo.

I still can't believe we are supposed to make these decisons   It's not like we went to med school.  Best Wishes! 

Thanks Sherry I'll do that. I've decided not to do chemo and will start on radiation soon. 

NewatThis-mine was 23,stage 1, grade 1

Hello everyone.

Had lumpectomy surgery with my right breast last May 3. Today is my firts visit with my doctor... the stage of my cancer went up to stage II after  finding out that my tumor size was bigger to what they have seen in my ultrasound & mammogram. My doctor discussed to me that they needed to put me again to do another surgery because there are cancer cells left in my surgical margins. My lymph nodes test is negative. ( the good news i have ) After knowing i will do another surgery & waiting my oncotype result i have decided to make a step to make an aggresive decision. I decided to do the masectomy this time with reconstruction and hoprfully this will be the last surgery for my BC. I never thought how could this affect me emotionally, i have try my best to save my right breast. But if it will give more problem & worry in the future, i have to let it go. The oncologist mentioned to me if my oncotype score fall to intermediate or high, she'll recommend the chemo for me. I'm crossing my fingers!

Intermediate Oncotype still uncertian about chemo treatments- This is going to be a bit lengthy but I feel the need to give as much background as I can. I found a lump in my right breast about a year ago, I didn't think much of it because I have fibroids. I had my yearly mammo scheduled for October so I thought I would wait. In September my husband was diagnosed with Prostrate cancer (also diagnosed with MS) so I put my mammo off so we could work thru his diagnosis. Funny thing, he asked me what I thought and I said "if it were me I would have it removed, if I ever found out the I had BC I would have my boobs removed" well 6 mo. later I would have to make that decision. I went in on 4/1 had the mammo, US and biopsy all within 2 hours. The results came back that I have BC...my FP set me up with BS before I knew the results so after I got the news from her it was off to the BS. The BS did an exam and went over the report with my options. The comment that stuck out the most for me was "looking at ur mammo I would have said see you next yr..but looking at the US tells a different story" ...hhhmmmm? I was set on a double mast (not a fan of my large breasts) but BS, PS and DH all thought that a lumpectomy would do just fine, and if I wanted to I could go in at a later date and have reconstruction. Had MRI - negative for any other areas of concern. So on 4/25 I had a lumpectomy. Final path report IDC and DCIS 1.8cm Stage 1 Grade 2 0/4 nodes ER+/PR+ HER2-

I met last week with the RADOC and on Tuesday of this week with the MO. My Oncotype is 16 and he left the decision of chemo up to me. I have kept a very positive attitude just as we did with DH and his cancer until now. This has been the hardest and most agonizing decision I have had to make. I do not like being in the intermediate range. Sometimes I think it is a no-brainer why would I want to go thru chemo and side effects for that 2% difference? but then the what if's take over..(I know there is always what ifs? but this one is in my control). I also want to add that I am 48 and my DH is 46 and we have 3 children - 21, 16 and 13. I know it is a personal decision and we are all different but it is still very hard. 

Paula, our stats are almost the same with two exceptions: I had a micromet in one node and my Oncotype was 17. I was 58 and you are 10 years younger. I chose no chemo as the chemo had a benefit of maybe 2-3% for me whereas the possibility of permanent se's from chemo hovered at around 5%. It is a very difficult decision. I am happy with my decision now, one year later.

Paula,

Every situation is different, I know.  First mammogram said my lump was .7 cm, followup mri said 1.2cm, and the lumpectomy said 2.5 . My oncotype came back at 19.  I am strongly hormone positive, per my oncologist. Anyways, I met with a second oncologist for a second opinion, each of whom spent nearly 2 hours with me. The first onco presented my case to his practice. Their opinion, which I learned yesterday morning: the chemo benefit to be gained would be modest (you've probably seen the numbers). The most benefit is the 5 years of hormone therapy.  The risk I would be taking by skipping chemo and going straight to radiation is reasonable.  So, last night I decided. I scheduled simulation today, and am not doing chemo. For the first time in 6 weeks I don't have diarrhea, and I slept through the night without crying. I'm divorced,  55 years old (diagnosed on my 55th birthday--I want a do-over!), have an 18 year old daughter.  I wish you only the best.  

NewaThis-glad you were finally able to get some answers and make a dicision.  That is the worst part.  Once you know your treatment things seem to start falling into place.

NewatThis - Whatever you need in terms of support, you will find here with so many wonderful and caring new breast friends.  You can also private message (PM) any of us if you would like.

Thank you all for the help and support....this is an awesome site. 

I decided against chemo and went in for my simulation last week and start rads today. I can't say that I'm not nervous, but I believe that is somewhat normal and I will be fine once the first one is over. I haven't heard back from MO on when I start Tamoxofin, would like to get that started so I can put my mind at ease on that as well.

Have a great day and a nice Memorial Day weekend.

My oncotype score was 20 and I decided to have chemo. The oncologist told me I could Probably go either way. I just wanted to throw the kitchen sink at it, even if it was maybe not necessary. I don't have any regrets. I think you need to make the decision that you feel comfortable with. I have three young children, and heck I am the only one who does homework with them.