What was your Oncotype score? And treatment?

hi, I was diagnosed at 45 years old had an oncotype of 11. I was offered chemo due to my young age but with no node involvement it didn't make sense to have it. I had 36 rounds of radiation and am on anti hormonals for 5 years. Good luck with your decision. I know its a hard one.

Hello,

I had an Oncotype of 5 so I chose no chemo. I had 25 rads and am about to start hormonal therapy. For now, I'm choosing to do ovarian suppression + aromatase inhibitor. Nervous about it, by my onc says that it will 20% more effective than tamoxifen for me.

Thanks for the update, Sweet Hope. I'm so glad you didn't have lung ca on top of everything else; that must have been a pretty bleak period for you.

It's too bad you weren't given your Ki-67, which is the replication rate of the cells in the tumor; it gives you some idea of how fast growing (duh) and aggressive the tumor is. As you say, knowledge is power.

I can answer your question about why 29 nodes: When the ALND is done they simply take out that whole fat pad in which the nodes are embedded. Some women have fewer in there, some more. Some pathologists are a bit more compulsive about digging out every last one than others. So the number tested can vary wildly. In your case, given that only the one turned out to be positive, it's kind of too bad you had to go through the full dissection. I guess the good news side of the equation is that you know the rest of them were clear.

Hope you're holding up ok through the chemo. Hang in there!

I am 35 years old. Diagnosed 12/1/14. I am stage 2a, no nodal involvement. My oncotype is 15. I too had LVI but my MO says that is all factored into the Oncotype score. A MO at Johns Hopkins also said that they do not look at LVI alone and that the Oncotype trumps everything. My MO says no chemo as it would give me less than 3% benefit. I will get radiation and hormone suppression for 5-10 years.

My oncotype score was 11. Stage 2, Grade 1 IDC. I had a lumpectomy followed by 33 Rads treatments and currently on Tamoxifen. 4 years since my DX. Tamoxifen is no walk in the park but SEs are manageable.

Diane

Bumping the thread by replying. Oncotype 19. Negative sentinel node. No chemo. Will start AI soon. Age 56 at dx.

Oncotype Dx score was 29, which is on the high end of intermediate. We later found out the cancer spread to 2 lymph nodes, which made me an appropriate candidate for chemo. I did AC + T. In the past Oncotype Dx was used for just none negative hormone positive breast cancer. Now, It can be used in women who have 1-3 nodes positive.

I was 58 at DX; 21 onco-score. No LVI or nodes. Decided on chemo. Feeling great 2 yrs later! My decision to do chemo was based on the fact that I did not want to look back and have regrets, should I have a recurrence...but, we just don't know, even if we do have chemo, do we?

Kimmer, I would probably not do chemo because of your grade and onco-score. A few suggestions: Maybe you could get another opinion or ask if you are a candidate for the mammaprint test...? Any family history? Did you have the BRCA testing done? Are you in overall good health otherwise? Hard decisions. Good luck with yours.

Hi Kimmer:

I note some comments above about the recent TailorX findings for patients scoring 0 to 10. Just a reminder to all that those recent TailorX study results are from node-negative patients:

http://www.nejm.org/doi/full/10.1056/NEJMoa1510764...

Regarding your last question, you are correct that some node-negative patients do receive chemotherapy. These might include HER2-positive patients, in which a chemo plus trastuzumab regimen is indicated [EDIT: (and being HER2-positive are not eligible for OncotypeDX for invasive disease)]. Among HER2-negative patients, it could be some patients classified in the intermediate risk group (score 18-30) or high risk group (score ≥ 31) by Oncotype Dx Recurrence Score ("RS"). Or even some patients in the low risk group, such as those with scores at the higher end of the range (closer or equal to 17). Apparently, some patients do not select treatment in accordance with their Oncotype test results. As explained in a publication about use characteristics:

"Chemotherapy use is not always associated with Oncotype DX RS. The most obvious reason for this is that the decision whether to use chemotherapy is a choice made between a doctor and a patient on the basis of many variables. Despite being at low risk, a younger patient with a large tumor may perceive that she would be more comfortable receiving chemotherapy in hopes of risk reduction, despite the intent to follow the RS value in determining the treatment plan. Conversely, an older patient with significant comorbidity and a high RS might make an educated choice to forego chemotherapy despite the high RS."

Like Keepthefaith said, if you wish to pursue it, you may find a second opinion very helpful whatever you decide. Different oncologists explain things differently. You may find further discussion with another MO helps you to understand better or more about your diagnosis, personal risk, and the strength of the data supporting the use of the Oncotype test for decision-making in node-positive Stage IIb patients. Quite often, I wish I had sought a second opinion about endocrine therapy.

BarredOwl

Kimmer, I am llB, 2 positive nodes and extensive LVI. My oncotype Dx was 13. I was nervous about MO saying no chemo so I got a second opinion. Second opinion oncologist said that if it had been prior to TailorX study I would be having chemo for sure. He said chemo would only provide 3-5% improvement and not worth the side effects however he said he would recommend it to my MO if I want it. I don't, I just needed to hear it from another source. I had some things that happened that left me feeling unsettled but now I feel like I have done my due diligence.

I was diagnosed at age 42. Stage IIb, triple positive with one positive node. Given that I was triple positive and grade 2, they didn't even run an oncotype- just said chemo was necessary. I don't regret it as my BMX showed pCR but I am curious (purely scientific curiosity) what my score was. I guess it doesn't matter now but just wanted to share my experience

hi luv joy... What was your ki-67? Mine was 25 with an onco of 1

I had an Oncotype of 15 with one 4mm node, but no LVI or extra capsular extension. My ki67 was apparently 25%, but my mitotic score was only 1 (slow growing cells). Some oncologists don't think ki67 is reliable. Oncotype goes beyond pathological grade and looks at the activity of certain genes. It does include ki67 but there must be other genes that counteract it. With all of that, I was still told that based on non-oncotype factors, chemo would give me a 10-year benefit of 5%. For me it wasn't enough to go through with it. Now I'm on tamoxifen for at least a year (bone issues) until I can switch to an AI. Wishing you all the best.

You can see on my profile my info and treatment. I decided to do chemo because my MO also stated that Oncotype wasn't as reliable for pre-menopausal women (although the consulting MO at MD Anderson said it WAS, but still recommended chemo)... Supposedly I had about a 3% benefit from chemo and a 13% risk but my MO said double that and that would be my benefit and risk. Another consulting oncologist said that wasn't true. So I dunno, I just did 4 rounds of TC to feel better about it. Wasn't bad at all.