IDC + lymph node Premenopausal Oncotype score ? Need for chemo

I'm close except post menopause and oncotype of 10. This is my post from another thread:

I'm not sure if I am relieved or not! Met with the MO. I thought since there was a micro met in one lymph node it would be automatic chemo. She said with my oncotype being only 10 that chemo would probably be over treating. She said a couple of years ago they probably would not have even discovered the micro met. Old treatment would have been to remove more lymph nodes to check for more positive ones but I think we are just going to monitor those. So, except for the pills (aromatase inhibitor) I guess my treatment is over! I feel like it's gambling and the stakes are my life! It's hard to not do every treatment available but there are risks in those too! I guess I won't know if this is the right decision for years.

I was recently in your very shoes. Not an easy decision. I had one positive lymph node (Macromet 8mm) and an Oncotype score of 12. The opinions of doctors were all over the place. (The consensus was that they were slightly in favor of chemo.) I was told I would get a 2-3% benefit at best -- possibly a 0% benefit -- and the final decision was left up to me. After many hours of careful consideration, I decided to forgo the chemo. Hopefully, I made the right decision. I am going to be put on 10 years of Tamoxifen. And currently, I am going for 33 treatments of radiation and my doctor is radiating the lymph nodes. (I had a lumpectomy so needed radiation anyway.) I was 46 at time of diagnosis and I am premenopausal. Get as many opinions as you need to feel comfortable making a decision. Good luck!!! . . . BTW, I was also told "standard of care" (according to current NCCN guidelines) is to give chemo. However, they are doing clinical studies right now to see which women (with 1-3 positive lymph nodes) can safely skip chemo. . . Tumor biology also comes into play. If I had anything aggressive about my tumor, I would have opted for chemo. (I did not - I am stage 2a, grade 1, highly ER+/highly PR+, Her2- and the tumor was only 1.4 cm.)

fastwalker, good for you. I can't imagine getting chemo at 12. Back in 09 I was almost alone in not getting chemo with a positive node. Now there are plenty of us.

Welcome to you superiuschantgal! We are so glad that you reached out to our community. Here is a link to information on our site that discusses the Oncotype score. We hope that this is helpful. Stay connected here and let us know what you decide. The Mods

Srh242 - Right back at you:

Although Oncotype Dx can provide some prognostic information in select premenopausal women with lymph node-positive breast cancers, it is not used to guide treatment for these women. Researchers have not yet studied whether it can help predict chemotherapy benefit for lymph node-positive premenopausal breast cancers. - See more at: http://ww5.komen.org/BreastCancer/OncotypeDX.html#...

I hate Komen but they sum it up nicely.

Glad you were able to make a decision, superiuschantgal!

You may want to join the July 2015 Chemo thread to meet and discuss with others as you go through chemo together. (There will surely be an August 2015 thread started soon!)

We hope this helps and we look forward to hearing more about your journey, and helping you along the way!

--the Mods

Hi 4pink101, yes I'm taking tamoxifen for 5 or maybe 10 years. So far I've been ok with tamoxifen, the only thing is I haven't been getting my period. I've menstruated only 3 times since starting tamoxifen June of last year 2014. I've been going to my gynaecologist for ultrasounds and I have a little endometrial thickening. I've had 2 endometrial biopsies so far in the last year. This is my only issuewith tamoxifen.

Hi 4pink101, no they didn't recommend RO. I also got immediate reconstruction but wasn't offered RO they said because I had a double mastectomy. I'm not sure what to tell you regarding this except I myself worry about recurrence. Especially now I have a bit of thickening happening on my implant. I had an ultrasound and the radiologist told me not to worry it isn't malignant but they are keeping an eye on it. They've already scheduled me for my second ultrasound in September. Hope that helps

Hi4pink101, my margins were 4mm. But I don't really understand what it means to tell you the truth.

Hi 4pink101,

All I can tell you is that I feel it's important for us to take the tamoxifen given our diagnosis. I'm sorry but you got me in a bad time with the experience of tamoxifen. Yesterday I had another endometrial biopsy because of thickened lining as well as they found a few cysts on both my ovaries with one that's more concerning because it's a complex cyst. Of course I'm freaking out now. I'm going today to a lab to get blood work done for the CA 125 test. I'm sorry but I really don't know what to say to make you feel better about taking tamoxifen except that we need to take it despite these side effects. I'm now trying to figure out if I should get a hysterectomy.

Good luck and a big hug to you

Thank you 4pink101

Pink - I've been on tamoxifen for 6 months now. I have hot flashes and that's all. I did chemo and my hair has come back better than before while on tamoxifen (I've been taking biotin too). Now who's to say what's to come, but so far so good. There are a lot of ladies that have taken tamoxifen with few side effects or none at all. They just don't post. We tend to hear from those having difficulty because they are looking for some answers.

Nancy

Hi 4pink101,

I can tell you that aside from these ovarian complex cysts, I've been doing ok on tamoxifen. I think I need to learn to handle some challenges that may pop up and then it will work out fine. I haven't lost any hair and I haven't gained weight. Except for some joint pain and constipation I'm doing ok.i wouldn't be too scared. I also didn't do chemotherapy because of my low oncotype score so that's why I feel I need to take the tamoxifen.

Sorry if I scared you before, I really didn't mean to.

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