Oncotype score of 19....chemo or no chemo?

I would advise getting a second opinion at your closest teaching hospital .. Look for the best. Look at my stats. I got a 3/3 split on the chemo decision .All my opinions were from 2 great Boston hospitals. Didn't end up doing it.

I would get a second opinion too just to see what they say.  I had a similar dx.  I was 45 at dx and stage 1 with ER/PR+ and grade two tumor with oncotype of 18.  I got two opinions.  One said no chemo and the other thought I could benefit from chemo.  The main difference in our dx was that I also had LVI present in my pathology.  That means that even though my nodes were clean, there was evidence that a pathway was established for cancer cells to travel by blood through vessels.  This is what scared me the most so I did opt for chemo.  I also had a 4 year old little one at home when I was dx so that also factored into my decision.

Sorry sistercoyot that you have to join us and are in this position ...

 I am with Ziggy pop...you need to get the details as to why they are recommending

chemo. Are you her2 positive  or do you have LVI ( as mentioned by Mdg)?

Difficult decision to make, getting more than one opinion is a good idea.  I also had an oncotype of 19, my BS and onc both recommended chemo initially.  I had requested the oncotype test and when given the results the MO left it up to me and didn't try to encourage/ discourage my decision in anyway.  I had LVI and 2 micromets in the nodes.  I have had a hard time with Tamoxifen but my MO says must keep taking especially because didn't do chemo.  I was afraid of chemo, but do second guess my decision at times, never thought would feel like I was 80 from the Tamoxifen at 43.

sistercoyote, do you know what puts you at stage 2?  I had an onco of 21, gray area. They are currently doing trials on the benefit of chemo for intermediates that will be out  next year! There is another test called a mammaprint, that tests more genes. I did not get that one done. You  might want to ask your MO if that is an option to get more info or if it would be more confusing...

after much thought and hesitation, I opted for chemo. My MO pretty much left it up to me, but did say that if it were her Mom, she would recommend chemo. I am 58, healthy and decided this is my one chance to kick it to the curb, so I need to take advantage of it. I dont think I could face myself or my family down the road with a recurrence if I didn't do all I could. From what I understand, the chance of a local recurrence,  is less than distant recurrence (mets)...so, in case I had some rogue cells floating around, I wanted to get rid of them. I had no node or LVI.  With that said, it is a personal decision and you have to do what's right for you. I don't regret my decision.  Luckily, my chemo has been fairly easy so far. I hope you get the answers you need and can have peace with your decision. It is a hard one.

I was 63, stage 2, oncotype 19, estrogen positive also, however, I have lymph node involvement. My doctor advised chemo. I went for a second opinion which agreed with the first. So, I had chemo, Taxotere Cytoxan. I did use cold caps to keep my hair, and they worked. I had radiation afterwards which was easy.

sistercoyote, if it's any consolation, it took me until a couple of weeks ago for it to sink in. I was DX'd in Sept.  I think what you are feeling is "normal". I hope your Dr visit goes well on Friday. Are you taking someone with you to the appt? You might want to jot down some questions before you go, if you have some. I recorded my visit with my MO when I went. Good Luck! Keep us posted.

sister coyote... This part is the worst! I was running a demanding seasonal business, trying to research at night, making second opinion appts. The worst for me was that I had to make sense of a split decision on chemo... 3 yes and 3 no....I hid in a dark room with my ipad and bad tv when I was trying to get through the decision making process. It sucked!!! I had access to great Dr.s in Boston.. But the I had to still make the decision myself.

It gets better once you make your decision. I just had my first post BC mammogram and all if fine. All of that BC angst is slowly disappearing to the past as I move forward with life. 

Good luck with your appointment. Bring all your questions in and make sure they are all answered. You will make the right decision whatever it is.

hi Sistercoyote,

Welcome to the club no one wants to join! I just wanted you to know that the early part is the worst! Before I got diagnosed, I swore that I would never do chemo. Ha! Easy to say when it is theoretical. I got three onc opinions ( even though my Oncytype score was 26). Mainly it was a process/ way for me to get to where I needed to be - all 3 told me to get chemo. I squirmed but I did it. I am three years out .

I think your story might be different - yours score  is lower,  It is a very personal decision. 

I just want to add that as you try to " compartmentalize" what is happening, be open to taking some anti- anxiety drugs or anti- depressants. You may not need them but this disease has both physical and psychological dimensions. I definitely needed something to help me sleep and to manage my fears in a way that I could find joy each day.

Good luck with your journey! 

Best,

Beau

sister-sounds like you made your decision. I just wanted to chime in that my diagnosis was similar to yours. IDC 1 cm ER/PR+ and oncotype was 18. No node involvement. Both my onc opinions said chemo was not needed and the SE would outweigh the benefit. Good luck!

Ginger, looks like we had same DX . I just got my results back and also got 18 ( and 11 for distant recurrence). I don't have any oncologists yet since I have to go for reincision and excision  biopsy (other breast MRI biopsy showed ATypical Lobular Displaxia)Feb 4.

If everything comes back clean I will probably not require chemo either.