Oncotype Score 27.....chemo?

rn4babies,

It looks like we are very similar in our diagnosis.  I had bilateral, mixed ductal and lobular, 1.3 and 2 cm (stage 1c, multifocal) 44 yrs old, strong family history.  My oncotype's were 13 and 25.  My oncologist took my case to the tumor board and 2/3 said do chemo and 1/3 were strongly against it.  I got a second and third opinion.  They all said do chemo, two wanted TC x 4 and the doctor from MSK wanted me to do dose dense AC +T (which really scared me).  I did the TC x 4 (finished 1 year ago) and had radiation (all after a bilateral mastectomy).  The chemo wasn't fun for sure, I had a hard time, but now 1 year later it feels like a long time ago and I can say I did everything I could to prevent recurrance. 

Let me tell you those few weeks when I was trying to decide what to do was VERY stressful.  Good Luck to you in whatever you decide.   

I am also sorry for what you are going through.  My score was 23, and I did chemo.  I was 44, with no family history.  In your case, with a grade 3 and strong family history, I would do chemo.  My onc. quoted my a higher % than 4, but regardless, I woudn't chance it.

I have heard or read that they may realign the oncotype categories based on the tailor X trial, so your score of 27 may end up in the high risk group if they do that.  I can't remember where I got that info.

As Diane said, hang in there, and hugs to you!

In my opinion, you should do chemotherapy. My oncologist and I discussed before she sent my specimen out that if I was in the intermediate range, she would recommend chemo because of my young age of 42.   I did Taxotere and Cytoxan x 6 neoadjuvant.     It wasn't easy-peasy, but I tolerated it pretty well......best of luck to you! 

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I had a IDC grade 3 oncotype 27 and I did TC x 4. My oncologist gave me a choice also but from what I read later the Taylor study puts you in the chemo group if your oncotype is above 25' you are not randomized as the immediate group is! I am glad I did chemo I would worry even more than I still do. I hope the chemo takes my 18 percent recurrence rate down much lower and with the Al it goes even lower. Good luck. Kathleen

Hello, everyone. I just saw the oncologist today, and have pretty much the same situation as the OP--an oncotype score of 27, stage 1A (on the border, some have called it IIA--it was 2 cm), no lymph nodes, but a high grade 2. My mom and aunt both had breast cancer (though older then me, and I am 64, but very aggressive types). I am scheduled for chemo, but was having second thoughts until I read this thread. Is it true that some studies put 27 in the high rather than intermediate range? I am very scared of the possible side effects, but I think more afraid of not doing everything possible to prevent recurrence. Is anybody in the same category here who decided only to go with radiation and hormone therapy? Oh, another thing; the oncotype found that I was PRnegative, not positive. so I will have to revise my profile. ER positive, PR negative, and HER negative.

edith...according to the most recently published TailorX study, you are in the catagory of patients that chemo is being recommended.

https://www.cancer.gov/news-events/press-releases/2018/tailorx-breast-cancer-chemotherapy

Anyone over the age of 50 with an OncotypeDX score of 26-100 the benefit of chemo should outweigh the risks.

Until recently, it was not known if patients with “intermediate” scores would benefit. Your score, 27, previously would be considered a high intermediate score. Now, with Tailor, it would place you in the high risk that would benefit from chemo.

That said, ultimately, it will be your choice. Clearly, there will be patients with high scores that will not do chemo. They may have other illnesses and or risk factors that might make chemo objectionable. Physicians review carefully patients medical histories before making final recommendations. With respect to side effects, without a doubt, some patients do suffer side effects. On these threads you will see that while some patients do have difficulty, many do not. Also remember that many patients who do well do not seek out this type of website with these threads. They do well and just move on with their lives. Hopefully, that will be you.

Good luck

I had IDC and DCIS, stage 2, grade 3, onco 29. I chose not to do chemo because only a risk reduction of 3%. I'm two years out and doing great. No regrets. My surgeon says I've had a charmed recovery.