Help...Thoughts about chemo w/ no oncotype available....

I'd take the advice of your MO regarding chemo over your RO or BS.   Your MO would be the one (hopefully) that would be familiar with the most recent studies/recommendations on systemic treatment for BC.

I was 43 at diagnosis, similiar stats to yours only my tumor was larger (1.4cm with 25% of that being DCIS).  I was able to get an oncotype score though and it came back 15, so no chemo.  However, my MO was on the fence about chemo before I got that oncotype score.. because of my age and the original biopsy said I was grade 3 (surgery pathology changed it to grade 2).

You are in a tough spot. You say you had a re-excision (due to unclear margins?).  Yet they didn't have a large enough sample for oncotype testing? That seems kind of odd. 

Unfortunately, the docs are pretty much just making educated guesses. Your MO may leave it up to you to decide whether to do radiation/hormonals... or add chemo as well.  You can always get several opinions from MO's... and then you ultimately need to make a choice that feels most comfortable to you.

Best of luck to you. 

I'm with you, that I like to get opinions of my other cancer docs but like SusansGarden said, I'd give weight to my MO's opinion.  Your MO should be able to discuss your risk of recurrence with and without chemo, so you can see the expected "benefit." 

FWIW, my biopsy path report said my tumor was grade 2 and 0.8 cm. Initially my docs said that I may be a candidate for chemo because I was young (46). The final path report showed grade 1 and 0.5 cm. My MO disrecommended chemo based on size and grade. (I also had very wide clean margins and clean nodes, no micromets) She even disrecommend oncotype, so I don't have a score. (I believe the test has 0.6cm as a minimum size, but I can't find it on their website.) She strongly recommended tamoxifen because I'm higher ER+.  I also did rads. So one option is to consider your total Tx plan.  Also, I'm a few years older than you and appear to be in peri-menopause now. My MO said my risk of recurrence would be lower if I were post meno so in cancerland, early-ish menopause can be your friend! So just an FYI there are a lot of factors. (this might seem completely off-the-wall but some young women choose to remove their ovaries to reduce their risk. Probably won't be recommended for you but FYI)

I agree that this is an educated guess. So much of cancer Tx is based on statistical analysis. My sense is that very small tumors are less commonly detected so there is less statistical data to go on, for any cancer Tx and possibly oncotype specifically. Some studies group all Stage 1 patients together but in terms of tumor size by volume, there's a big difference between a 0.5cm tumor and one that's 2 cm. So it can be harder to make an educated guess.

Don't forget you can get a second and third opinion. Your insurance usually pays. Good luck.  I found this whole waiting-to-decide-chemo to one of the most stressful periods of this "journey."