Update on my wife's diagnosis/treatment.

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Swami7774
Swami7774 Member Posts: 24
edited August 2016 in Just Diagnosed

Last Thursday she had a lumpectomy. Yesterday the surgeon called and said she was able to get excellent "margins", which I think means she got all of the tumor. No need to go back in.

Of the 7 nodes she extracted for testing, one came back positive. So it's on to chemo, then radiation. We were hoping to avoid the chemo, but I look at it this way: had the surgeon taken only 5 or 6 nodes and missed the cancerous one, we'd be facing much more serious problems down the road. We are meeting with an oncologist next week to map out the plan.

Thank you all for your continued words of support.

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  • Denise-G
    Denise-G Member Posts: 1,777
    edited August 2016

    Thanks for the updates about your wife! Wishing you both only the best!


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  • Anonymous
    Anonymous Member Posts: 1,376
    edited August 2016

    A way I looked at it was that I was cancer-free post-lx, because I had close but clear margins. And now on to the clean-up phase. That made me feel better--that I had less cancer in me than I had before I found out I had it. If you get my drift.

    Your wife will do fine with chemo and rads. It's a grind, but temporary, and you'll both make it through. There are discussion links for chemos, rads, etc that were helpful to me so I hope you'll find them equally supportive.

    Hugs

    Claire in AZ

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  • Swami7774
    Swami7774 Member Posts: 24
    edited August 2016

    Thank you, Claire. That's exactly how we're approaching the next phase: a clean-up.

    We're learning very quickly that half the battle is mental.

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  • Swami7774
    Swami7774 Member Posts: 24
    edited August 2016

    Thanks, Denise. Every bit of support helps.

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited August 2016

    Swami:

    Thank you for the update. Good luck to your wife as she moves forward with her treatment.

    BarredOwl

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  • msphil
    msphil Member Posts: 1,536
    edited August 2016

    good news i will continue to keep wife n Us All in my prayers tell her to keep Hope n be Positive it got me thru im now a 22yr Survivor Praise God. msphil idc stage2 Lmast chemo and rads n 5yrs on Tamoxifen

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  • Swami7774
    Swami7774 Member Posts: 24
    edited August 2016

    Thank you very much, msphil. My wife was also Stage 2(initially they thought Stage 1 but the size--2.5CM--forced a change in status).

    She met with the oncologist today and was told she is borderline chemo/no chemo. Apparently there's some reevaluation test of existing data that will find out where, on a scale, she is. 0-18 means no chemo. 19-28 means maybe. Over 28 means definitely. I've never heard of this and wonder why it wasn't done immediately.

    But if she does get chemo it will involve 4 sessions, followed by radiation, followed by 10 years of hormonal therapy(Tamoxifen, I assume). She is preparing for the worst(chemo) and considering cutting her hair short already.

    This will be a journey, but we (me, my daughter and wife) are going to get through it together.

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  • Swami7774
    Swami7774 Member Posts: 24
    edited August 2016

    barredowl, thanks for your words of support. Everything helps.

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  • Evalynn
    Evalynn Member Posts: 9
    edited August 2016

    I am also a 2 a and scored low on the onco dx test. My oncologist said chemo would cause me more harm . I had a lumpectomy so I will move on to 35 rounds of radiation then 5 years of Tamoxifen .

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited August 2016

    Hi Swami:

    The Oncotype test for invasive breast cancer is a gene expression profiling test. This test determines the level of expression of 16 cancer-related genes and 5 reference or control genes ("21-gene test"). It is used in certain patients with hormone receptor-positive, HER2-negative disease to inform decision-making on the question of whether to add chemotherapy to endocrine therapy.

    It is most commonly done on tumor tissues obtained from surgery, because patient "eligibility" or suitability for the test is clear upon the availability of pathologic staging (including lymph node status).

    The test reports provide a "Recurrence Score" from 0 to 100, and include "prognostic" information about average risks associated with various recurrence scores from clinical data, and information comparing outcomes in patients with various recurrence scores treated with either {chemotherapy plus 5-yrs tamoxifen} or {5-yrs tamoxifen alone}.

    Here is a sample of node-positive report from the commercial provider of the test:

    Sample NODE-POSITIVE report

    NOTE: The node-positive reports are based on different studies from the node-negative (N0) reports in different kinds of patients (node-positive versus node-negative), and they provide different types of risk estimates. Thus, it is critical to look to the content of your personal report.

    Be sure to request a copy of your wife's report for your review and records, after the oncologist explains it to you.

    By the way, the standard risk categories for the test for invasive disease based on some initial clinical studies*** are as follows. (They are currently the same for node-negative or node-positive patients.)

    Low-risk (Recurrence Score < 18) (i.e., 0 to 17)

    Intermediate-risk (Recurrence Score 18 to 30)

    High-risk (Recurrence Score ≥ 31) (i.e., 31 to 100)

    Clinical trials are in progress in node-positive patients that are prospectively assessing slightly different ranges, but these ranges are currently investigational. For example, the on-going RxPONDER trial is evaluating whether adjuvant chemotherapy is beneficial in patients with hormone receptor-positive, HER2-negative breast cancer with 1-3 positive lymph nodes and a Recurrence Score of 25 or less.

    RxPONDER clinicaltrials.gov entry

    As you know, I am a layperson with no medical training. The above is for information only, and all information should be confirmed with your medical oncologist, to ensure receipt of accurate, current, case-specific expert professional medical advice.

    Depending on the results and/or the advice you receive, you may wish to seek a second opinion from a medical oncologist at an independent institution regarding the chemotherapy decision. To minimize the potential for treatment delays, you may wish to consider lining up a second opinion at this time.

    Best,

    BarredOwl

    ***(1) Dowsett (2010), http://jco.ascopubs.org/content/28/11/1829.full.pdf

    ***(2) Albain (2010):

    Abstract of original: http://www.thelancet.com/pdfs/journals/lanonc/PIIS1470-2045(09)70314-6.pdf

    NCBI version: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058239/pdf/nihms227230.pdf

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