treatment decsion after Oncotype score of 29?

I, too had a 7mm tumor that was Grade 2, but my Oncotype score was an 18 and I was told that chemo would only offer an additional 2-3% benefit of avoiding recurrence.  Furthermore, I knew that my tumor was growing at the slowest rate (like a Grade 1) and chemo is generally not effective in those cases.  I did not do the chemo.  

Your score may have come out higher than mine because it is dividing more rapidly, and therefore chemo would work better on it.  Your surgical pathology report might have that info. or maybe you could check it with your doctor.  In your case, with a score of 25, I think I might have done the chemo.

Recommend a second opinion at a National Cancer Institute-designated center http://www.cancer.gov/researchandfunding/extramural/cancercenters. This is a hard decision and you need the best minds giving you the information you need to choose your treatment. Be sure to read the Oncotype reports carefully and take a look at the large variations in the intermediate group. Until the Tailor RX trial is published, for those of us in the dreaded intermediate category really won't know. Other factors (type of cancer, family history, etc.) can influence the decision too. My MO recommended chemo, the MO at the Cancer Center did not. Bottom line, we have to have the information to make the best decision we can at the time. Know you are surrounded by good wishes as you make this hard decision. 

I had two small grade 1 tumors, both less than 1 cm. But I had a high proliferation index Ki-67 of 30%, so they are dividing more rapidly. With a micromet in one lymph node and Oncotype scores of 23 & 26, chemo was recommended. If there are any of these rapidly dividing cells floating around my body, that chemo better be tracking them down and nailing those suckers! 

Rosebud,

Since you are getting the Oncotype done, I'd not worry about the size yet.  The Onco will give a lot of helpful information.  I was 1.5 cm and told I was on the cusp for chemo.  My Oncotype score of 30 made it necessary.  

So sorry, all these decisions are difficult.  

Mine was 9mm, no nodes, ICD grade one.  Oncotype score 28.  I wanted to be as aggressive as possible.  Had a bilat mx and chemo.  No reconstruction.  That was over 4 years ago.  No residual problems from either that I am aware of.  Am on an AI.  Don't know for how long.  

Good luck with this difficult decision.

GoLilly - it's a very difficult decision until you get the oncatype score - and even then, if you get in the dreaded middle range (18 to 30), it's not easy.  I hope that your oncatype score makes it an easy decision either way.  Chemo is not to be taken lightly.  It can be very hard on your body.  Let us know when your oncatype score comes in.

My story:

A
year ago found what I was told was a simple cyst. Had my routine mamm
and untrasound. They found nothing. 3 months ago there was localized
pain and minor change to dimension of cyst. Went in to see PCP in June
referred for mamm and ultra sound this time they saw something on the
screen.

I am 47 (body type, personality and health of a 27 year old)
pre-menopausal. One of those 7% of why did this happen maybe its the
7-13% body fat with dense breasts my whole life? Cant be too thin or
overweight need to be just right - LOL

I was dx 7/11/14 with stage 1 infiltrating ductal carcinoma. modified
Nottingham grade 2. 1.5cm r breast tumor. No findings anywhere else.
ER/PR+ Her 2neu negative. Lumpectomy with sentinel node dissection (3
nodes) No findings in the lymph nodes. Braca1/2 reflex bart test clear.
Oncotype score 26(intermediate with 40% chance of inaccuracy).
Waiting on mamma print. Just started localized direct target radiation
to R breast and .07cm margin near chest wall. It has been suggested i
do chemo then tamoxifen.

My questions are around quality of life:

What would you do if you were me?

I have been told by onc I have a 95% survivorship with R breast after lump and rad and 60%
survivorship for rest of body. If I add chemo it goes up 3-6% and if I
add tamoxifen it goes up 17-20%. Putting me in the 86-89% range. BUT
what about "QOL" Quality Of Life issues???

With chemo and tam the SE's as you know and have read here are
horrendous. I have never been able to tolerate hormonal deviations. At
17 when my menstruation began they put me on ortho pills to regulate
menses they made me worse overall but periods were more regular. Weight
gain, headaches, nauseous, very depressed and angry.

I take nutritional supplements now and they regulate my periods well
but they are not helpful/contraindicated or recommended for chemo or
tam. I now have osteoarthritis and I have not started any hormones or
chemo yet.

My neurophysiological system is very sensitive.

My 17 year old daughter says don't do it. My sister and brother in
law don't do it think of quality of life. My husband says lets wait for
mamma print get a second opinion AND lets see what other women like
yourself have to say about their quality of life. My friends say do it.
My family all physicians and in the cancer field say look at the
numbers. I am not a number though. I am an individual who
philosophically is against toxins in the bodymind.

Many thanks, warm regards,

Jyoti

Thoughts, Questions, Comments, Feelings

Rads/chemo/anti-hormonals are NOT the enemy.....cancer is, and cancer cells are terrorist cells that will kill you FOR SURE if given the chance. This is one time to absolutely look at the numbers; if they don't add up, then don't do any particular treatment. If they do, then the treatments are the Navy Seals working FOR you to help save your life. I did chemo, rads & 5 years of an anti-hormonal because the numbers said they would give me the best chance of a long cancer-free life. Chemo was not fun (although I worked all the way through it and did everything else I needed to do & most of the things I wanted to do too), rads were not bad (actually felt my energy increasing), and I did not have problems with my anti-hormonal. I am, in fact, in better shape now than I was going in. Don't let the fear of side effects, which may or may not happen, stop you from doing what you need to do now to possibly save your life!!!

newbcny, do you mind me asking about the stage etc. of your dx? I'm still waiting for my oncotype test, and even though the BS said she doesn't expect it to come back high, there's no guarantee. My tumor was under 2 cm with no node involvement. I REALLY don't want to do chemo, but do worry about recurrence. I won't get my onco results until July 18 so am kind of crazy. How long did your test take to come back? I was told there is only one lab in the entire nation that do these tests so it takes 3+ weeks.