Intruducing myself

Hi Mary, and welcome to Breastcancer.org! We're sorry you have to be here, but really glad you found us. As you can already see, our wonderful Community is full of helpful and supportive members, always here for you.

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Just a clarification: OncotypeDX testing and genetic testing are two different things to determine two different courses of action. OncotypeDX assays a sample of your tumor for 17 genes and is an adjunct to the other histological and biochemical features of your tumor—and for IDC that isn't clearly suited or unsuited for chemo, it determines the advisability of prescribing it, based on predictions on how much benefit (distant recurrence, overall survival) chemo would add to hormonal treatment. A “low-risk" (0-17) score indicates the tumor wouldn't be very responsive to chemo and the risks would outweigh the benefits. And it does not take into account type or extent of surgery, as it is almost always done on a bit of the tumor removed during your mastectomy or lumpectomy.

Genetic testing has nothing whatsoever to do with chemo vs. no chemo. It does not test your tumor. Preceded by a counseling session (required by insurers), it takes a sample of your blood and analyzes it to see if you carry the most dangerous mutations to the BRCA 1 & 2, PALB and Chek2 genes—all of which mutations can dramatically raise your risk of not just breast cancer but also ovarian, colon, pancreatic and melanoma. (Patients with BRCA 1 or 2 mutations have up to a 50% risk of developing breast cancer—and with BRCA 2 mutations, triple-negative is likelier to occur. They are usually counseled to have not just BMX but also oophorectomy, because the chance of ovarian cancer is so high). Mutations are more common in descendants of ethnic groups that historically rarely intermarried, so the mutations were likelier and likelier to be passed down with every generation. (Ashkenazi Jews in particular, because until the 19th century intermarriage was unheard of and we were concentrated in--and restricted to--Eastern Europe's “Pale of Settlement").

So OncotypeDX is for chemo vs. no chemo. But genetic mutation testing is for determining whether to do prophylactic removal of both breasts and ovaries, as well as more aggressive regular screening for melanoma, pancreatic and colon cancers.

That is a good question for your onco. You will have to get your port first. ...nothing moves fast in the medical community unless you have a trip planned. If it was inflammatory breast cancer, I think they would want to start quickly. The her2 may also move you up faster. There are some really smart ladies that will chime in that can help advise. Best of luck with your treatments

Only my second post.  I have read many of the discussions and found them helpful and comforting.  I certainly understand the feeling of your life being on hold!  I was diagnosed with DCIS in my left breast the middle of August, had a lumpectomy, bad margin, MRI, 4 more biopsies and the result was two IDC small spots in my right breast- after much discussion with my BS, decided on DMX then had to find the right plastic surgeon.  Having DMX on 10-26 with reconstruction started immediately (expanders for implants).  What type of reconstruction was a big question for me and hope I made the right decision.  Would suggest you may not make your trip but hope all goes well for you. 

We are planning a cruise in mid-April 2017 and I can't get a straight answer as to whether or not to keep that plan!  Mainly will depend on if I need chemo and won't know that until about 10 days after the surgery.  All the waiting - and not knowing- makes me nuts.  I can handle about anything but need to KNOW what will or might happen in order to get my head around it.

marytou - even if your ovaries are removed your adrenal glands still produce hormones that convert to estrogen. Most ER+ postmenopausal women take aromatase inhibitors for anti-hormonal therapy for at least five years, just as premenopausal women are prescribed Tamoxifen. The three aromatase inhibitor drugs are Arimidex (anastrazole), Femara (letrozole), and Aromasin (exemestane). I was postmenopausal for nine years prior to diagnosis with breast cancer due to a total abdominal hysterectomy and bi-lat oophorectomy, and I still have to take an AI drug. Here is a link that explains this very well from the BCO main site:

http://www.breastcancer.org/symptoms/diagnosis/hormone_status/treatment_hrpos

I hope your visit to Moffitt goes well, it is a big facility - it can be a bit overwhelming. I am right down the street from there if I can be of any assistance.