Oncotype DX, grade 3, 1 poz node?

I would agree with what has been said.  I would also say that the oncotype score is just one piece of information-- the stage, grade, size, etc. all have to be factored in.  Also, when it comes to chemo, your current health will be a factor.

I had a slow growing tumor-- the thinking from two major hospitals was that I would have a lumpectomy and radiation and hormonal therapy.  I had a lumpectomy, clear margins, no nodes, no LVI--- seemed perfect.  Then my oncotype came back in the "gray area"   Given my "younger" age at dx and my good health, we decided on 4 rounds of A/C as insurance.  

 It was not overly pleasant, but not completely horrible.  I was able to work full time and I have young children--I was not able to do much more, but frankly, I found radiation more exhausting.  Lost my hair, etc..... but here's the thing--it has all grown back and then some..... 

This will be a hard decision no matter what the oncotype score.  For me, I knew I would never sleep a full night again unless I did everything possible to eradicate this--others feel differently.  In the end, it is really up to you once you have all the data in front ofyou.  Dr.s rarely "tell"you what to do-- unless there are significant medical indicators (like a really high oncotype-and even then you get to make the final decision).  

I tolerated it all pretty well and I am convinced it is because I was in great health going in..... 

I am 2.5 years out of treatment and feel great--just had my 3 year oncology visit, all is well--- 

good luck-if you have to do chemo, definitely go to the chemo threads--lots of great tips.  If you don't or decide not to, we will all cheer you on!!!

 My mum had oophorectomy in 2010, but not for that reason. She had a cyst in one of her ovaries after 2-3 months of taking Tamoxifen. She was on Zoladex besides Tamoxifen. There was a chance that the cyst is cancerous. Luckily, it was not. It was a benign cyst. She stopped taking Tamoxifen and no further Zoladex injections were needed. Now, she is on Arimidex. I guess that is because she has no ovaries, therefore she is postmenopausal and Arimidex is good for women who are through menopause. 

Etherize, I hear you.  The trade-offs for your treatment options must be as complicated as all get out.

I hope that you've got a coordinated treatment team to help coordinate all this.  Are there any NCI centers that also have  HIV expertise that help coordinate your care?  Maybe a good research university medical center?

I hope that all goes well for you and that your team can help set you on a successful treatment with minimal side effects.

Hugs,

Meg 

Etherize,  it seems like they keeping throwing you curves about treatment.  It's probably good to take deep breath and regroup.  Just make sure you've got the full story before you make a decision,

I seem to remember that CMF can be done with pills rather than infusion (IVs).  I  think it was an on-off for two weeks periods.  

Check with your MO about what the  CMF regime actually entails  to get the full picture of what  you would actually need to do.   It might be worth seeing if you can talk to  folks who have  gone through these treatments.  I think the  American Cnacer Society or y-me.org might be a good source to find out.

From a distance it sounds like your MO is taking quality of life issues into account in view of the side effects you're getting from the HIV meds.

A friend told me that the breast cancer journey is like being on an obstacle course where new obstacles are added without warning.   I hate the suprise hurdles. ;->

Sometimes its hard to roll with  new  directions when we've had our fill of unwanted suprises.

Hang in there.  We're all pulling for you.

Meg 

Bgud, congratulations!!! I know you're relieved. Your onc sounds like a wise man, explaining to you that the chance of recurrence w/ chemo only improved by 1 percent. So what do you do now -- radiation?? hormone therapy?

 I get my DX score in a couple of weeks (I'm out of town now). I'm hoping for similarly upbeat news, but I'm also prepared for the recommendation that I have chemo.

 Anyway, good for you!! 

Etherize, I just got my score today: an 8. I was elated when I saw it, but the MO reminded me that the graphs she was showing me were for node-negative women, and she considers me node-positive with my micromets. She says the standard of care for women w/ my stage/type is still chemo/radiation/hormone therapy. She's leaving the ultimate decision up to me: 1) 4 rounds of chemo 2) no chemo; or 3) participate in a clinical trial looking at women exactly like me: ER+PR+Her2- with BOTH 1-3 nodes involved and an Oncotype score of less than 25. The trial is designed to see if they tell a cutoff Oncotype score for us positive-node women below which chemo offers no real benefit.

So I'm not sure which way I'm going to go. I had wanted to avoid chemo, but the 4 rounds sounds more doable than the 6 or 8, and I wonder whether, later, I'd wished I have had that extra "insurance."

Anyone else here left their treatment decision up to a clinical trial?

Etherize, I'm sorry your score was as high as it was. Our diagnoses were so similar, except for your tumor being slightly larger. I wonder what accounts for the big difference in Oncotype scores.

If we both have chemo, I guess we'll be starting about the same time. 

Etherize, I'm so sorry that you got  a high Oncotype score.  I hope your MO is able to adapt your BC treatment to mitigate interactions with your HIVtreatments.

I'm also hoping that you've used up all your bad health luck and that  good luck starts taking hold.

*hugs*

Meg 

I had a lymsectomy and my tumor was 2.1 a little over stage 1 and my grade was 3. Margins clear and my lympe nodes were negative. I am er+ pr- and her- . wondering if my oncotype score will be high because of grade 3, well its out now. I wonder whats treatments I will be having?

Lisa, as Etherize said, the Oncotype score can surprise you, either way. My tumor was a grade 3, and I had node involvement, so my diagnosis was quite similar to Etherize's. My Oncotype score came back an 8! After reviewing the options, I still decided on chemo plus radiation, so I would know I did everything possible to prevent a recurrence. In the end, the choice is yours. Good luck.

According to Professor John Boyage of Sydney Adventist Hospital Team, all tumour grade 3 patients need chemo and radiotherapy even if no lymph node involved!

Grade 3 tumour divides fast and has high recurrence rate

We are blessed to have Chinese herbs from Chinese Oncologist specialise in traditional Chinese Medicine to balance our whole body system

I took 22 types of herbs, 4 days after chemo and my energy recover without neuropathy, able to cook and go to hospital independently!



AC is too detrimental, it affects my nervous system and causes liver inflammation



My liver gamma rose to 388 with fever and infection of egg size of sebaceous cyst on my back and in hospital for 40 days! Paclitaxel is more gentle to our body as it carries less risk!

12 weekly paclitaxel plus 2 cycles AC



3.2 cm ER+ *Grade 3 *8/18 Nodes

DX 19 Aug 2011 Mastectomy

I found HOPE in Meditating Ezekiel 37 and Psalms 91

Love from Kheng in Singapore
3 anointing cheers!