Confused

Get a second opinion.

Then go for a 3rd, 4th or more if you need to.

I know nothing about Mammoprint or Oncotype - for me the only option was neoadjuvant from the 'git-go'. There are many here who do have knowledge about them though.

I do know that it is more common to do adjuvant Chemo for most rather than neoadjuvant, except for IBC, though neoadjuvant Chemo is niw being done more often for the other types.

You might ask to speak with another member(s) of the Tumor Board at the Facility for clarifaction/explanation.

Yes - you (any of us) need to be respected with our choices. Also needs to have better communication.

As I said - I know nothing about Mammopri t or Oncotype but there are others who do - will probably be here before long.

Hi Nulyte, I am sorry you are in this situation. If I recall correctly mammaprint is only used for patients with no more than 3 positive nodes. This test may not be a good predictor in your case because you had more than 3 positive nodes. Can this be the reason why your MO changed the plan? I agree with the advice your already received to get a 2nd and a 3rd opinion if needed and also speak with your MO again. She recommended AC+T but I am sure will find other options once she knows more about your heart condition.

I was clinical stage 1a before surgery (very small tumor and no signs of nodes involvement on imaging.) After surgery, was re-staged 3a. I didn't have mammaprint or oncotype tests done because they are not reliable predictors for women who are at a more locally advanced stage, i.e. have more than 3 nodes involved. When I asked my MO about oncotype she said she would advise chemo no matter what the oncotype says, so no point in ordering it.

I understand you don't want chemo and it is your right to refuse it should you decide to do so. It is your MOs obligation to advise you on the standard of care that is appropriate for your case. If you feel she is not taking into account your individual situation like age, other conditions or anything else that might matter talk to her about this.

Best of luck with whatever decision you make!

I have really thought about you situation, because it could happen to any of us. First, I understand the disappointment with positive nodes. Mine were negative, but I was prepared for anything. In all the studies that I have read, if mine would have been node positive, I would have done the chemo. I am very conservative and pragmatic when it comes to taking drugs I don't need. (Pharmacy School.... ya gotta love it) You did not mention any meeting with radiology because I assume you would not get radiation treatment with dcis. If for any reason there is any IDC in either breast that went undetected, the chemo would take care of that. Where there is DCIS, there can be IDC. How does that Catholic prayer go, "of all that is seen and unseen...." I would caution about shopping for the answer you want, you might just really need the answer you need to be healthy. MO's do have a way of encouraging chemo. But when the risk is small, they usually do not push the subject. When faced with a situation like this, I say to myself and God, "please help me see what I need to see, to make a good decision."

Did you get back a detailed pathology report? That can be helpful in weighing the pros and cons. There are tools on the internet that weigh in survival factors that might be worth having a look at.