Chemo vs no chemo for low Onco score

Hi kimosha,

I was also diagnosed at the age of 45. You can see my treatments below. I had bilateral bc so I had two oncotypes. One side was a 5 and the other 19. I had BMX and chose to do the TC X4 because of some focal LVI. This chemo regime is doable but not a walk in the park either. One thing you may want to think about is that I have been slammed into menopause because of the chemo, so no need for me to do the ovarian suppression LOL, but I am suffering the effects of meno. In hindsight, I would not have done the chemo if the LVI was not there. Good luck with your decision....its a tough one.

It will be great if you can avoid chemo. But I see you had three positive nodes. Maybe you should get another opinion.

Best wishes.

I would think that positive nodes would trump any test. With positive nodes, you KNOW that the cancer has already spread outside the breast. Plus you are young & it's ILC. I, myself, would be very uncomfortable NOT doing chemo. At very least, I think you should get a second opinion!

I'm older but had a very similar onc test and ER/PR diagnosis. Also 2 nodes with micromets, one extra nodule. Uni, Rads and Tamoxifin. I was almost menopausal at the time. No chemo. My MO didn't want to over treat too, as long as the the Tami works, and I'm planning on 10 yrs, she felt it would be over treatment and might curtail my options if there is a reoccurrence. 2 yrs out I'm doing well. Its difficult to think it might come back but I think that's something that can happen to any of us.

You also need to keep in mind that the oncotype is based on initial studies of post menopausal women, rather than premenopausal, though there are ongoing studies with premenopausal women. I would definitely get a second opinion. Tamoxifen is the most important thing for you, but I am 43, had a 2.0 cm tumor, no lymph node involvement, oncotype 16, and just completed 4 cycles of TC, and I feel very confident in my decision. Took my first tamoxifen this morning. Good luck. These decisions are not easy, and there are never any black and white definitive answers.

Hi

I see that you had 3 positive nodes. Everyone is different, but for me, with positive nodes, I would choose chemo. I did not have positive nodes, but was higher on the onco test, so I chose chemo. I would get a second opinion. Research around nodes, chemo and the oncotype continues to change.... not really sure what the best practices are now (I am over 5 years out)

I was treated at MGH and Dana Farber-- lots of good oncs there for second opinions.

You might want to look into participating in the Rxsponder trial http://www.swog.org/Visitors/S1007/patients.asp It's a stage 3 clinical trial trying to validate smaller studies that show the oncotype testing is relevant for node positive (1-3 nodes-I think) BC. I'm node positive & did not have chemo. I was given statistics & told I needed to decide for myself. My oncoscore was "4". I had IDC & was grade 1. I was not able to participate in the trial I mentioned above. Currently just over 2years into my 5 year Tamoxifen course. It was rough at first, but really felt I needed to ride it out. I took my time making my decision. Didn't really sink in that I wasn't having chemo until I was laying on the table getting RADs.