Oncotype Dx score 24 : chemo or not?

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Anna1966
Anna1966 Member Posts: 5
edited May 2018 in Chemotherapy - Before, During, and After

Hello,

I had a lumpectomy and sentinelle gland removed 3 April 2018, and have just received my results of the oncotype test giving a score of 24. My oncologist told me as I fall into the intermediary group (score 18 to 30) there is no clear evidence on the benefits of Chemo, so its up to me. Its clear that radiotherapy and hormonal therapy are highly recommended. So, having seen 2 more oncologists, who have all said the same thing, I am still none the clearer as to whether I should take the chemo?Has anyone else been in this situation? One thing is clear, I need to decide quickly as it is already 7 weeks since my operation. Apparently, chemo has to happen before the radiotherapy in order for it to be the most effective. My goal is to reduce the risk or recurrence to a minimum.

Any advice would be gratefully received.

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  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited May 2018

    I had an Onco of 24, also. Since my tumor was ER+PR-, considered more aggressive, and I am at very high risk due to gene mutations, I decided to do the chemo. It wasn't fun, but it wasn't awful. I fo not regret my decision.

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  • Djt
    Djt Member Posts: 264
    edited May 2018

    I was told all through 2 lumpectomy, and all tests, with clear margins, and no lymph node involvement I would not be getting chemo. On my onco visit to set up radiation, I was told......they recommended chemo. They did my onco test without my knowledge . Big news to me. I was 28. But my geology testing wasx all neg. I choose to get it. Half done at today's date. You need to think it through, each had their own ups and downs. I figured as I am retired, and went through 3 surgeries with it, plus 2 seroma aspirations, I'm going all the way.

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  • Anna1966
    Anna1966 Member Posts: 5
    edited May 2018

    Thanks for the feedback. I hope your treatment is bearable. Are you going have radiotherapy after the chemo?. I have read that the group with score 18 to 30 are considered intermediary risk, and for this group the benefits of chemo are not clear. I think I will opt for the chemo, as I don't want to regret not doing it later. Good luck.

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  • keepthefaith
    keepthefaith Member Posts: 2,156
    edited May 2018

    anna, you didn't post your stats, but you can always ask for a mammaprint test; it gives you a high or low score. I read somewhere on one thread that the TailorX clinical trial results are supposed to be out the first part of June. I had a 21 onco-score and did chemo. Chemo wasn't as bad as I thought it would be, although it wasn't exactly a walk in the park. MO helped me manage SE's. I have read that the higher the grade of tumor, the more effective the chemo is said to be. Good luck. Hard decisions.

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  • ChelseaSculler
    ChelseaSculler Member Posts: 73
    edited May 2018

    Can you wait just about 2 weeks? The TAILORx trial results, which were done to help answer this question, are being released June 3 at the oncology conference.

    My surgery was a week after yours and my Oncotype is 22--when I met the MO 2 weeks ago, he suggested we wait and make a decision on June 4. It's definitely later to decide than I'd like (and I'm feeling the anxiety of not knowing) but I decided I'd hate to decide against it and start radiation and then discover chemo would have been more use than expected.

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  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited May 2018

    Anna, the Oncotype report should include a graph showing the predicted percentage of benefit from chemo for your tumor biology. Your oncologist should have provided you with a copy of the entire report, which would include that. If he did not, call the office and ask for a copy, and ask specifically for that information. It may be very helpful for you.

    I know you want to make a decision shortly and I understand that but I believe that best practice is for chemo to start within 12 weeks of surgery, so you do have time to do the Mammaprint test if you wish and, in this situation, it would probably be a very good idea.

    I'm not sure waiting for the results of the Tailorx trial would be helpful as it focuses on benefit for those with a score between 11 and 25.

    My score was intermediate but on the lower end and I did not do chemo. I understand what a difficult decision this is.

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  • Lisey
    Lisey Member Posts: 1,053
    edited May 2018

    I highly suggest anyone in the intermediate range get the mammaprint as a second opinion.  There is no intermediate with that test, only low and high risk.  I had a 20 score oncotype and decided I'd do mammaprint and if it came back high risk, I'd do chemo.  It came back low risk, so no chemo for me.  They never did bill me - it's been 2 years now.  I'm willing to pay the $500 if I do get a bill but I think they wrote it off... 

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  • Anna1966
    Anna1966 Member Posts: 5
    edited May 2018

    After consulting 3 oncologists, the general opinion was not to do chemo. However, none of them even suggested the mamma print test.

    I made the decision not to do the chemo and have started radiotherapy. However after reading more about he mammaprint test, I do wish I had done it. I think I will ask for it, even though I have started radiation, just to be sure. Although if it comes back high risk Im not sure that chemo is still an option after the radiation. Just hope comes back low risk and confirms I did the right thing. Its a lottery!


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