BCI Test Shows High Risk - Resume AIs Now that I'm In Year 8?

Thanks Rozem - I think I just need the encouragement.

As you said, I'm hoping the s/e may be easier this time around. Last time when I started AIs, I was severely weakened from surgeries and chemo - I started AIs 3 weeks after my last chemo and my entire system was depleted. This time I'm strong and healthy at the start - I'm hoping that might make some difference.

Alirena - our BCI results look similar. This is the way I read my results:

If I were at Year 1, without AIs I'd have a 46% chance of recurrence during Years 1-10 (46 women out of 100 will recur without AIs). That was the info on that second page of the report that gives results if the test has been ordered at diagnosis.

But I've been taking AIs for 5 years and have not recurred. So the only years left that we're concerned about are Years 5-10. So if I were now at Year 5, my risk of recurrence would be 27% during Years 5-10 if I don't take AIs (27 of 100 women will recur without AIs). If I do take AIS, then I'd reduce that risk of recurrence in Years 5-10 to 10.5% (10.5 of every 100 women will recur with AIs).

That's a difference of 16.5% in absolute terms from Year 5-10, meaning that 16.5 fewer women out of 100 will recur if they take AIs during Years 5-10.

In terms of percentage, dropping my chances of recurrence from 27% to 10.5% is roughly a 60% improvement (10.5 is 38% of 27).

Of course it's entirely possible I missed something, and I'm all wrong. I have an appt with my MO next week to go over all of this - we'll see how close I got. And I think you raise a good question about these numbers - are they personalized or just extrapolated from studies.

The Onco test was not available for node positive patients 8 years ago, so I never had it.

Claire - Intermittent is my exact plan if the s/e get too much. My MO is very willing to work with me on that.

Had a great discussion with my MO last week about my BCI results. It turns out that I'd interpreted them pretty correctly.

However, my onc added some info about those recurrence rates. She said that the recurrence rate figures lump in two kinds of recurrence - women who have a new primary in the contralateral breast, and women whose recurrence is a distant mets. Roughly 10% of the recurrences are women who have a new primary in the contralateral breast. Since I had a BMX, the risk of a new primary in the opposite breast is close to zero for me. However, the flip side of that is that should I recur, it will almost certainly be mets.

The other thing she said was that these figures assume that the test is being done in Year 5, and measure the risk of recurrence in Years 5-10. However, since I've gotten as far as Year 8 with NED, my risk is even lower than it was at Year 5.

Overall, she said that instead of my current risk being 27% as stated on the BCI report, it's something probably around 10-15% due to the fact that I have no contralateral breast and I'm already in Year 8. And if I go back on AIs, instead of my being able to bring my risk down to 10% as stated on the BIC report, I could probably bring that risk down to around 5%.

So it appears that while the BCI tests the genomic makeup of the patient's individual tumor, when reporting these risk assessments, the BCI doesn't take into account what surgeries or treatment the patient might have already had, and what year they are in. That's where our MOs come in - they can help us individualize these general risk assessments and apply them to our particular case.

Bottom line - we agreed that there is some benefit to going back on AIs, and I agreed to give it a try. If the s/e get too bad and alternate measures (vacations, changing from on AI to another, etc.) don't help, then at that point we can make a decision about stopping it again.