Help needed: To get Chemo or not

I've been going through the same dilemma today after getting my Oncotype Dx. I had a bilateral mastectomy in November after a diagnosis of DCIS and invasive ductal carcinoma (Stage 1); ER+, PR+, Her2 neu-, BRCA negative. My Oncotype is 18. My oncologist said he is not leaning toward chemo, but it's my decision and if I feel strongly about it, they will proceed. Both of my tumors were small, less than a centimeter, and with everything else, my overall risk for recurrence is low. Still, I wanted to do my homework and make sure I was making an informed decision. After talking with my family, I've decided not to do chemo. I'm 49 and still healthy (except for the cancer), and with a low risk I'm more interested in my quality of life now. I'm finishing a Master's degree and working at a job I love, I don't have children. As my healing progresses after surgery, I feel better and better. Because I'm ER+ and PR+ and premenopausal, I will need Tamoxifen for many years.

For my circumstances, chemo does not feel like a good option. I think, however, that it's a decision we should all be able to make for ourselves. That's what my oncologist was trying to tell me, I think. I do hope you find what is right for you! For me, being on the low end of the intermediate Oncotype scale seems less of a risk than if I were a 25 or something higher.

Hi Chandi- my Oncotype score is 19, and in a phone conversation with MO she recommended chemo. I see her on 1/9, I'll hear her out, but I'm unsure if I'll agree to chemo. She may talk me into it, who knows. I know if we search hard enough we'd find a Dr to say no chemo. But is that the correct answer to not have it mastesize years down the road? Unknown gray area.

TAILORx was to publish on 12/31/17 its trial results on "intermediate" Oncotype scores - chemo vs no chemo. I can't find anything showing that it published.

Best of luck to you.

CindyNY, with grade2 er and pr positive, no nodes and oncodx of 19 she should be recommending hormone therapy not chemo.

1a here, strongly ER/PR+ HR-. Because of my relatively young age and grade 3, despite an oncotype of 20, both my MO and a second consult plus my BS all leaned towards chemo. I will never know if it was the right choice but it is done.

Chandi, it's a good idea whenever you're unsure about how to proceed to get a second opinion from an expert (in this case an Oncologist specializing in breast cancer, ideally at an NCI-designated cancer center in an academic institution). Doesn't matter if the uncertainty is related to a grey area in medical knowledge, an arbitrary cut-off placed on something that is really a continuum, or things about your personal history (medical or other) that make it a complicated decision. Even get a third opinion if you're still unsettled.

Chandi - had I not have had nodes positive coupled with a IDC aspect my MO would have nixed chemo. In fact until pathology report after surgery I was believing I wouldn't have to do it, only radiation. If you can avoid it, good for you! You can be asked to me monitored with more frequency, that could help put you at ease.

My oncotype was 20 and I did the chemo. It was the hardest decision I have ever had to make and I will never know if it was the right one. I do have permanent side effects but perhaps I can't blame chemo wholly. I have no advice except I was there and I don't envy your difficult choice.