Chemo or not? Oncotype borderline...

The Look Good, Feel Better program is awesome! I second Lago's recommendation to get signed up for a session.

Tracy,

My tumor was 1.2cm.  I had a bilateral mastectomy with DIEP Flap reconstruction on August 6. Then I learned that my oncotype was 18. I struggled for two weeks with what I should do. My oncologist is very informative but wouldn't "tell" me what to do. As a matter of fact, when I was leaning towards NO chemo, he would give me statistics on why I SHOULD and when I was leaning towards DOING chemo, he would give me statistics on why I SHOULDN'T. He is all about me making the best choice for me.

As much as I hated it, I opted for the chemo. I knew I would never forgive myself if the cancer returned and I hadn't done everything I could to stop it. I am on an every three week cycle of cytoxan & taxotere. Next Wednesday is my LAST CHEMO!

Has it been easy? Hell, no! but neither was my surgery.

Would I change my choice if I could do it again? Nope. I have the peace of mind knowing that I made the right choice for me.

I still have two procedures left for my DIEP reconstruction. However, I will find out tomorrow if I can postpone them. I learned AFTER my surgery that I am positive for Factor V Leiden heterozygous (a clotting disorder) and cannot take Tamoxifen. I am going to try to schedule my oopharectomy shortly after my last chemo so any remaining cells don't have any estrogen to prey upon. THEN, I hope to do the reconstruction procedures.

Hope this helps.

Hugs and love to all!

It's a hard time, but you can get through it and be really, really O.K.!!

@MENA - When my tumor size came back at over 1cm, doc was recommending chemo. I wanted to wait until the oncotype came back. Honestly, in my mind, the magic number was 15...if my oncotype was 15 or under, I wasn't going to do chemo. When it came back at FREAKING 18 - I had a lot of thinking to do. I am more of a factual thinker and not an emotional thinker.  I finally came to my decision by considering the following:

1. Doc said chemo was recommended for tumors over 1cm. Mine was 1.2cm. Fact is fact: 1.2 > 1.0

2. Oncotype intermediate range begins at 18. They didn't round it up to 20. There had to be a reason for that. Mine was 18. Fact is fact: 18 > 20.

3. If I was willing to lop off both breasts to reduce the risk of recurrence why wouldn't I do chemo.

I had to stop looking at chemo as a punishment and look at it as an opportunity. It was the opportunity to reduce my risk of recurrence even more. And now that I can't take Tamoxifen because of the clotting disorder, I have to see ovary removal as another opportunity to reduce the risk of recurrence yet again.

As I said before, my doc is GREAT at playing Devil's Advocate and not influencing my choices. I even told him that I just wanted him to tell me what to do and he said he wouldn't do that. The decision to choose chemo was probably the hardest decision I've ever had to make (even harder than deciding to take both breasts) but it was also the best decision I could make for me to be able to put my head on my pillow at night knowing that I did EVERYTHING I could to kick cancer's a$$.

mena, I wonder if one difference is menopause status. I'm 46 and pre-meno. My MO said that--all things being equal--my risk of recurrence would be about 1/3 lower if I were post-meno. (that's much more than my expected "benefit" from chemo and almost as much as my expected "benefit" from taking tamox for 5 years.) I know my doc looked at many factors. Because my IDC tumor was 0.5 cm, she disrecommended chemo but strongly strongly recommended tamox because I'm highly ER+.  So I think there are probably a lot of factors.

twins, you have such a good attitude. I'll be cheering you on next Wed for your last chemo Tx.

Now I'm wondering, why do I need: chemo, neulesta, 30+ radiations; then 5 years of hormone blocker therapy!!!  I am already post menopausal and have some bone loss, had a partial hysterectomy at age 32 and I'm 65 years old

ER+ >90 PR+>90  Ki67 >20%   Doc added chemo based on ONCO score of 34%.

What the heck, does this sound right? Anyone ?

Thanks LAGO, you made me feel much better.  I wanted to trust my Doc but just hate the idea of all this treatment but then again, I never heard anyone say the liked it .  I guess I never got to ask my MO the questions because I had no clue what to ask.

Thanks again Lago.  I did go to the chemo class however it was only an hour after I found out I needed chemo - needless to say I was so overwhelmed and distraught.  I have an appointment on Monday and will write down some questions.  Already had bone scan, and MRI, Doc knows I have degenrative joint disease; mild osteopenia and arthritis.  Tha's why I hurt so much from the neulesta I guess.  Anyway the doc had me on calcium and weight bearing just like you but then the nurse told me my calcium was too high to stop it...better check w/MO again. Thanks for sharing your knowledge

Didn't know about Claritin when I took the Neulesta but I am ready for the next time.  Glad to hear the first is the worst..Done!!

Just be sure to check with your onc to see if it's OK. You don't want to be taking something that won't play with your other meds.

Tricia there is a lot of good knowledge here but always check with your doctors before trying anything that could interact with your treatment. Many people have PMed me for my advice… and the first thing I tell them is I don't have a medical degree and I'm actually a designer. Sames holds true for anyone here on this forum.

So many of us here are dealing with chemo brain, mental-pause, ESD (estrogen sucking drug) brain atrophy or any combination… we probably didn't remember you name anyway

Love the color