Shelly, I was diagnosed with predominately micropapillary IDC in May of 2017. It is my understanding from this board and my research that, although this rare type of BC was once thought to have a very negative prognosis for survival, today it is considered the same or even a little bit better prognosis than regular IDC. The one thing that it seems to do compared with regular IDC is spread rapidly to the local lymph nodes but that spread is not prognostic of distant speed (i.e mets). Therefore, treatment is the same as for regular IDC. I could not get my MOs or breast surgeon to discuss the micro papillary aspect of my BC. Very frustrating.

My tumor was small (7mm) and could not be clinically detected, my grade was 2 but I did have 1of 3 nodes positive so my Stage is IIA. I am ER+ and PR+ but HER2 -. I had a Mammoprint done (rather than Oncotype test) which showed that I was "high risk" (albeit in a small way -- a score of 14 on a scale of risk from 1 to 100). Therefore, I did AC/T chemo and am on letrozone now. I had a lumpectomy but no radiation. One more oddity about my cancer is that I am both Basal and also Luminal with the Basal score a little bit higher. This is very rare if you are not triple negative but it is considered a worse prognosis than being Luminal alone. So that may be why I was "high risk" rather than because of the macro papillary features. Hope this makes sense. Polly

I could be mistaken, but I think the purpose of the oncotype and mammaprint scores is to not only show the lower risk for recurrence without chemo, but that chemo is not effective and, in some cases, harmful, if given to those with lower scores. "Chemo no matter what" is not the best choice if the numbers say otherwise.

I agree that the tests help determine which bc patient will most likely benefit from chemo. But I don't think chemo is more harmful to people at low risk of mets compared with harm to people at high risk of mets. Chemo has a harsh affect on everyone with some people having more permanent side effects from it but the side effects are not worse because you are in the low risk group. Its just that the risks of the treatment are not offset by sufficient benefit when the patient is low risk for mets. I am so glad these tests are being refined over time to help patients avoid treatment that is harmful to them without sufficient benefit.