Is chemo always necessary for a recurrence

hi BennyBear:

I am sorry to hear you are facing another bout of BC.

When I had my second bout, I was dx with stage 1. I had another mastectomy. I had negative lymph nodes.

I am only on Arimidex. No chemo, no rads needed. I did have oncotype test which was 14.

I was stage 3 with 2 positive nodes last time. It had been 13 years when I "recurred"

Wallan

It might depend on whether it's a new primary cancer or a metastatic cancer.

mom mom - what was your first Oncotype score? How old were you at first DX? I am so sorry you had to go through it again.

Benny: My onc had to push with insurance for the oncotype, but I was told anything after 5 years is considered a new cancer, not a recurrence of the old one. And my oncotype results were different than 9 years ago, which I would not have known but for redoing the Oncotype. In 2008, my score was 18 (I think). Just above low. Last year, my score was 26. And the ER and PR numbers were different. Of course, the TailorX study is out now

Nonomimi-I was 43 at first diagnosis. 52 at 2nd diagnosis.

Peace to you and yours,

M

A very well respected nationally known Cancer Center would not do an Oncotype on my recurrence because they were sure it was just an isolated local recurrence that was not aggressive. My gut told me otherwise. I saw a new local oncologist and he ordered an Oncotype at my request. It came back very aggressive. A second tumor was also found, so do not let them be so quick to dismiss Oncotype

Depends on type of cancer and location of metastasis. Mine is in lower back-sacrum, 5 tumors- radiation to relieve pain and shrink tumors pain was relieved after one treatment-had ten. Now back on femara, kisqali and zometa infusions suppressing hormones and cleaning up calcium and blocking cancer cell division. Got my first report of cancer reduction. Not on the heavy metal chemo. HR

Piksie, You may want to ask for oncotype just to be sure. My first MO said the same thing, but the second opinion wanted to know for sure, and sure enough it came back aggressive. Oncotype the first time was 16 (long story, but we did not know that before starting chemo...they did it to decide between 4 and 6 treatments). The second time it was 40. Radiation is definitely the best weapon for the local recurrence, but especially if it is in the lymph nodes, it's just not behaving, so being sure is important. Just a thought to consider.

Piksie, Do not hesitate to get a second opinion. The first MO who told me no, and refused Oncotype, is at probably the most well known, well respected Medical Center in the upper midwest. They are very conservative about chemo though. I wanted more opinions, because no matter how prestigious the institution, at the end of the day, they are human, and they do not have all of the answers. I could not wrap my head around why they would not use a readily available tool to asses the need for chemo, and were just assuming this was just an isolated unaggressive local recurrence. I was SO glad that I sought another opinion with a doc who's gut, like mine, felt that this was not behaving, and was likely more aggressive. He suspected the Oncotype would be high, but we were both shocked at how high is came back! Once presented with that information, the first Medical Center agreed that chemo was necessary. Never under estimate the value of a second opinion. Hopefully they'll do the Oncotype and determine it to be low risk, but any doctor should be supportive of you seeking a second opinion. You do not want to expose your body to chemo unnecessarily, because it has its own risks, but you also do not want to skip it if warranted. My local doc and I had the same opinion of mine (and as I said...I had a strong gut feeling mine was aggressive) ....... this is a cancer that statistically, should not have come back. It did not behave. It also did not behave in that it came back while on Tamoxifen, so it's possible it is resistant to some anti-hormonals. I did not want to put all of my "eggs in one basket" relying just on an AI. Chemo was my insurance plan. There is still no guarantee, but I know it's been treated appropriately giving me the best chance of avoiding metastasis. I will never ask "what if".

If your oncotype comes back low, you'll know with great confidence that skipping chemo was the most appropriate option. You'll never have the nagging "what-if".....

My onco type dx score is also 14. Just had lumpectomy today for recurrence after having DMX with complete reconstruction in 2016. I found the lump. Less than 1% chance of this happening.

They are recommending rads this time. I didn't have chemo or rads last time.

They say my tamoxifen didn't work. So weird.

I'm nervous about chemo.

Blessings y'all!