I had an oncotype score of 32. My ki-67 was 38%, biggest tumor out of six was 4.2 cm, and just had isolated tumor cells in lymph nodes. I had BMX and just started chemo (AC x 4 and T x 12). I will then have radiation and ten years hormone therapy

I was 47 at dx and had a BMX. Then 4 different Her2 tests to finally be found negative. Onc didn't trust surgery pathology since I had low Ki67 (5%) so he sent out for second opinion from Mayo. Oncotype was 7 (further proof I am not Her2+ per my onc). Finally getting treatment plan this week- either Tamoxifen or AI/OS. No chemo or rads. I am premenopausal but have ILC which AIs apparently work better on. But Hopkins onc recommended Tamoxifen, local onc suggested AI/OS so I am confused. They are going to talk to each other this week and then (hopefully) agree on a recommended course.

I am just so ready to do something, I feel like I have been waiting forever for a plan.

Mine was 16--I was diagnosed at 64. 75% ER+/97%PR+. Node-neg, clean margins. Only reason they even ran the test was that my tumor was >1cm, which put me in the “gray area” (BS’ nurse said they don’t order Oncotype DX for smaller tumors with the same profile as mine due to chemo almost certainly conferring little-to-no advantage; nor for tumors >2cm, with node involvement, or Grade 3 because chemo would almost certainly work on those faster-growing cells). MO said that adding chemo to rads+AI therapy would give me only a 1% added advantage. Not worth it, considering allergies to three major antibiotic groups, asthma, and the fact that as a musician neuropathy and hearing damage would end my career. Checked the various online tools for patients, and found that 1% would translate to only an extra 6 months of life--w/o mention of what those 6 months would be like.

If I were 10-15 yrs younger and had no comorbidities it might have been worth it.

Hi Mariaann, if you're talking to me, yes I really saved my hair during chemo! Check out this thread for pictures: https://community.breastcancer.org/forum/6/topics/835766?page=2#idx_42

My Onco score was 34, I had a Lumpectomy and taking Tamoxifen still.

http://www.medpagetoday.com/HematologyOncology/Bre...

Gene Test Helped Docs Plan Breast Ca Therapy

Recurrence Score assay prognostic for multiple outcomes

Oncotype 21 - 1.2 cm IDC, 98% ER+, 60% PR+, HER2-, 0 lymph nodes - I consulted several oncologists who all agreed chemo would be of very little benefit to me, and that radiation, an aromatase inhibitor (Arimidex) and a bisphosphonate (Zometa) would serve me just as well.

hi mammaries of the past,

We have similar diagnoses. My oncotype was 11 and chemo was not recommended. With a score of 11 I was told the benefit of chemo did not outweigh the potential risks. There are also some studies which have recently confirmed that those with scores of 0-10 who did not do chemo had very very low recurrence rates. And so, were ok in skipping chemo. I think it is the TAILORx trial.

Since you are ER/PR+ hormonal therapy will be the best chance for keeping it from recurring. The oncotype score assumes you will be receiving hormonal therapy. My 10 year recurrence risk with an oncotype 11 is 7 percent - assuming hormonal therapy - which I am taking. You likely didn't need radiation because you did mastectomy. I had a lumpectomy so had to do radiation.

You could have your ovaries removed but that is such a permanent solution. You could try ovarian suppression first with either zoladex or lupron injections combined with whatever hormonal therapy your doctor recommends. And then decide a bit down the road if you want the surgery. But many premenopausal women are just recommended to take tamoxifen. Butovarian suppression along with tamoxifen has shown some benefits. I did 15 months of lupron injections along with taking Femara until I went into natural menopause and am now just taking the Femara.

All that being said, you have to do what is right for your peace of mind. Discuss with your doctor. Hope this helps.

mammariesofthe_past

I note the comments above about the recent TailorX trial results for patients with Recurrence Scores of 0 to 10. Just a reminder to all that those recent TailorX study results are from node-negative (N0) patients:

http://www.nejm.org/doi/full/10.1056/NEJMoa1510764#t=article

Study Patients

The study included women 18 to 75 years of age with axillary node–negative invasive breast cancer that was estrogen-receptor–positive or progesterone-receptor–positive (or both) and that did not overexpress HER2. Patients had to meet National Comprehensive Cancer Network guidelines for the recommendation of adjuvant chemotherapy,(21) including a primary tumor size of 1.1 to 5.0 cm in the greatest dimension for a tumor of any grade or a size of 0.6 to 1.0 cm in the greatest dimension for a tumor of intermediate or high histologic grade or nuclear grade (or both).

No node-positive subjects were included, so the findings in this trial do not apply to your situation (node-positive) and do not inform understanding of your recurrence risk.

There are other studies in the node-positive setting, such as the recent prospective WGS PlanB trial which included some node positive patients. However, it would be best to discuss the results of the recent clinical studies in the node-positive setting with your expert medical oncologist, how robust the findings are and how these studies may or may not inform decision-making in your specific case, including exact nodal status and other relevant clinico-pathologic features (e.g., age).

You may find a second opinion very valuable.

Best,

BarredOwl