Low Oncotype score- Will Chemo give extra insurance?

Voraciousreader (or anyone else who can answer) - re: your statement that "Us mucinous gals, along with our tubular sisters, have our own NCCN guidelines which is separate and distinct from traditional IDC-NOS BC treatment guidelines"...can you explain more about the impact of tubule score & mucinous type on treatment? I had a BMX Nov. 20 (cancer on L, prophylactic on R). My tubule score was a 3 (overall Nottingham grade 2, with nuclear grade 2 & mitotic activity score 1). I had multifocal IDC, both solid and mucinous types, along with a 6 cm DCIS mass. Stage 1. No lymph node involvement, no lymphovascular invasion. Low KI-67 score (10%). Hormone positive, HER-2 negative. I am 32 years old. I will find out my Oncotype score next week. In the meantime, I'm trying to educate myself as much as possible so I can make an informed decision quickly. My MO is anticipating a low Oncotype score and thus no chemo. There was initially a question of whether or not the Oncotype test could even be run because my tumor size (0.6 cm) was right at the cutoff of how large a sample Genomic Health needs to run the tests. It turned out to be big enough for the tests, but if they had not been able to run the tests, my MO told me she would have recommended no chemo in absence of a Oncotype score, based on everything else she knows about my tumor.

Anyways, any additional info you can give me (or threads you can direct me to) on the effects of tubule score and mucinous type on treatment would be appreciated. Thank you!

And now, off to bed...'tis 2 am in my corner of the world, and last I checked, all medical professionals are still in agreement that sufficient sleep is, in fact, recommended for cancer patients. Glad some things are still clear-cut! :-)

adelaide...If you have a diagnosis of mucinous breast cancer, you can join us on our "Mucinous Carcinoma of the Breast" thread.  On it, you will find most of all the published research on this rare disease.  Your tubule score SHOULD NOT BE CONFUSED with Tubular breast cancer.  The tubule score helps calculate your "Grade."  Tubular breast cancer is a distinct pathology.  It is classified among "rare" breast cancers.

According to the information that you provided, you do indeed have excellent prognostics.  Furthermore, at your young age it was a great idea for your doctor to do the Oncotype DX test.  I would also recommend because you are young that you also receive BRCA genetic testing if it hasn't been recommended already.  Most young women, those under 45, who have a breast cancer diagnosis are usually screened for it.

While you wait for more information regarding your treatment plan, I highly recommend that you go to the NCCN website and read the Professionals version of the guidelines for breast cancer.  You will note that you have MANY choices.

Good luck.

http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

Also read the NCCN guideline footnotes AND pages 93-98 which discusses endocrine therapy. Also, last week's San Antonio Breast Cancer Symposium presented their ATLAS study comparing 5 and 10 years of Tamoxifen. Check that out as well.

Neugirl, I was in your exact position 1 1/2yrs ago. I had a score of 11 and really wanted to do chemo. I was freaked out to say the least. I was 46 at the time, one Onc said chemo just because of my age, but he didn't use the onco test and was more of a general onc.  I then went to two of the top Breast Oncs in NYC (Mt Sinai and Cornell/Weil) Both said, even at my age, chemo would do me more harm than good and that tamoxifen would be my best medicine. Even at my age. My tumor was grade 2 and was a mix of different forms. (a smorgasbord!). Tamoxifen is a form of chemo and works like a teflon, not allowing cancer cells to stick and form clusters. My Onc said although she wouldn't lose her license by giving me chemo with a score of 11, her colleagues would would most likely question her professionalism and think she had lost her marbles. This was concured by one of the TOP oncs in the country at Cornell/Weil. Once they described Tamoxifen's job, it made me feel much better about going that route and I haven't looked back.  Good luck with your decision. I know how you are feeling!!

elo...neugirl hasn't signed on to the discussion boards in over a year.  I often wonder how she is doing and also wonder whether or not she found a doctor to give her chemo.  The oncotype DX test is one tool that is used to help decide whether or not your benefit of chemo outweighs your risk.. May I recommend that your case be presented to the tumor board team.  Ask your oncologist about it and let them help you make a decision that is right for you!  I wish you well.