Chemo or Not?

You should do what you believe the best treatment is for you. I can tell you my situation I was 53 and had 2 tumors one ILC and one IDC grade 2 both 1cm. I had mastectomy no radiation. I was er+ 95% and pr negative less than 1%. No nodes involved. My oncodx was 34, high risk but I like you was worried about the long term side effects of chemo. I was in fantastic health and my surgeon and oncologist suggested chemo. I decided not to do chemo. I listened to the statistics and just was not convinced it was worth the reduction in recurrence risk. I am 6 years no recurrence. I did do 4 years of AI drugs. I have been off 2 years now and still have some arthritis and my ear still rings.

You should ask about having a 70-gene assay--such as Mammaprint, Prosigna (and a third, newer one I can’t recall)—performed on your tumor tissue. They are extremely helpful in deciding which “intermediate-risk” (and 19 is low-intermediate) Oncotype-scoring tumors are candidates for chemo. Their advantage over OncotypeDX is that they have no “intermediate” risk category, just “high risk” and “low risk.” One bco sister scored 20 but her MammaPrint came back “low risk;” another scored 21 but her Prosigna came back “high risk” and she opted for chemo. There was a study released (I forget the publication, but will look for the url) saying that these 70-gene assay tests can often allow more OncotypeDX “intermediate” patients than originally thought to safely skip chemo. But the converse isn’t true: low-Oncotype tumors (0-17) test “low-risk” in these 70-gene assays.