RxPonder study - chemo or not???

Hi Kim,

Your situation was the same as mine, however I went through this 8 years ago, when most oncologists would automatically give chemo for a positive sentinal node. Mine was bigger than yours being 1mm so it would have automatically been chemo.

After much discussion with my medical team they gave me 2 options, have chemo, or the other option was have my ovaries removed. I was aged 52 at time of diagnosis.

In the last 8 years there has been a lot of change in treatment and I occasionally see other women in our situation who don't have chemo. I was advised that they didn't think I would not get enough benefit to outweigh the risks from chemo. I also had radiation and am now at 7.5 years of taking femara. They are wanting me to do a total of 10 years of hormonal treatment. I may be switching to Tamoxifen soon, as Femara plus having the ovaries out, has caused a lot of bone loss.

I made the decision at the time, however as time has gone on, it has really worried me that I didn't have the chemo, however at this stage I am going OK, and probably at this point any benefit that chemo would have given me would be finished by now anyway.

Good luck with your decision. I would love to hear what you decide.

regards Ched

I ALMOST entered the RXPonder study. My oncotype was 19. I was having such a hard time deciding whether to do chemo or not I figured I would let them flip the coin (they literally just randomly assign you chemo or no chemo.) In the end I chose chemo and I am so happy that I did!! I know I did everything I could to beat this this. I can't imagine my anxiety level if I had decided not to do it. I was in the same boat as you - the doctor's could have went either way with me.

You must have a certain oncotype score to be considered for the study, so I assume you have had that?

With a pathology report showing low-grade cancer in 2 nodes, I received opinions from 2 sets of doctors and tumor boards at 2 major academic centers in Boston. MGH proposed randomized chemo and extensive radiation (RXPonder study = standard of care hormonal treatment with or without chemo). I went with the Dana Farber program recommending no chemo and no radiation but hormonal treatment coupled with a trial drug, Palbociclib (now on the market as Ibrance). Each set of doctors had a trial that they were pushing, and each recommendation was based on participation in said trial. In my opinion, at academic centers, the trial options skew oncologist's recommendations and make the decisions trickier for patients. Without a crystal ball, there is no clearly better path. Many of the stage IV BCO sisters had chemo at diagnosis... It is no guarantee... Each of us has to weigh our unique situation carefully, make a decision, and then have confidence that we have made the best decision possible for ourselves. Believe in yourself and your MO.

That was my case. One + node, my BS said that, instead of a full ALN dissection, I would get radiaiton to breast and lymph nodes. Then my MO ran an oncotype test and due to a low score (4), said no chemo. Also, I was low grade and cancer was ILC, which are not what chemo is good at destroying.