Please someone who;s better at math than I.....
I just read a great post from Beesie about how tamoxifen lowers risk of recurrence by 30-35%. I've been confused since I saw my MO to discuss my oncotype score. It gave me a 10% chance of recurrence and thanks to TailorX and my age, I do not need chemo with a score of 24.
However, I could have sworn she told me that without endocrine therapy, my risk of recurrence goes up to 30%. But that's NOT what she said is it? That's mathematically impossible. If Tamoxifen reduces recurrence by 30-35% then I am looking at more like a 13-14% recurrence rate WITHOUT endocrine therapy. is that correct?
I am willing to try the tamoxifen because I believe the science. I am only 6 months past my last period so that is why we're starting with Tamoxifen, even though I am 55 1/2. Eventually we will move to AI's and I'll cross that bridge when I come to it. She explained how that reduces the risk even further for me.
But for now please, someone who is better at math confirm for me that my risk of recurrence WITHOUT endocrine therapy is NOT freaking 30% when my oncotype risk was 10% with.
I bow before the human calculators and thank you in advance.
Comments
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Maybe she means that 30% of early stage breast cancer patients go on to develop MBC.
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mom3bunky, I can't figure out the math either and I always thought I was pretty good at it. Sometimes I think they pull these percentages out of thin air.
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GG27, I don't think that's what she was talking about. The 30% I heard was immediately following "if you don't do hormonal therapy...." At least that's what I remember and I went to that appointment alone, unfortunately. I don't see her until a month or two after I start the Tamoxifen, or I'd just ask her to clarify. Eventually will.
Darcys-mom, thanks I'm glad I'm not the only one who finds it confusing. I thought the stats on Tamoxifen were pretty scientific and firm given all the studies. I have NEVER thought I was good at math.
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I am not a mathematician, but from what I have gleaned over the years, your chance of recurrence doubles without the antihormonal. Mine was 8% with Tamoxifen, so I am assuming about 16% without. However, I have had the BCI test and it shows an increased risk after 5 years so I will be on the drugs for at least 10 years.
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Percentages are tricky things to understand, and with the uncertainty of what your doctor said, I can't tell you what she meant, but it sounds like you have it right that it would be 13-14%. There is a great difference between something being 30% or being 30% more (or less).
Perhaps you can look at it this way--Take a whole thing--be it a circle, box, pie, apple. Cut away 30%, or almost 1/3, and you have 30% of the original.
In your mention of 10% chance of reoccurrence, imagine you have 10% of a whole pie and someone tells you that you can add 30% to that slice. Will you have 40%--No. You will add 1/3 of the 10% or approximately 3.3% to your pie slice, for a total of 13.3% of the total pie.
Same would hold true for lowering risk. If you originally had a 10% chance of reoccurrence, lowering risk by 30% would take approximately 1/3 of your 10% risk away--or would reduce to 7%.
It always bothers me when health scare headlines pronounce that something increases your risk by 50% or whatever number they proclaim!! Sounds so scary--but in reality, it might be increasing the risk of something from 2% to 3%. Three is still a fairly low number but it is 50% more than two!!
Hope this helps ease your mind until you have a chance to clarify with your doctor.
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I tried to just keep it as simple as possible and I still don't get it!! When I do the cancer math under therapy, I get 30% mortality without, shortens life expectancy by 6.1 yrs. With therapy I get 20.4% mortality and live 1.9 yrs longer. Onco score =17 I think 11% recurrence rate. I do another predict tool and get that I am getting 3% added benefit by taking the AI. I don't fully understand any of it, but with therapy the numbers are better, so....I put up with my hair falling out and no red wine ever due to the hot flashes.
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Thank you ceanna for the confirmation. Yes I think that's it. I will certainly review it with her when I see her again.
ctmbsikia, yes when I did the calculator I got only a 2% point difference in with or without hormonal treatment.
You know what? I think it may just be best for me to forget the numbers and just move on. I've made the decision to try the therapies so what difference do the numbers make anyway. They only upset me.
Thanks much everyone!
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Momtobunky, I think your MO must have said that if you don't take Tamoxifen, your risk will got up BY 30%. Very different than going up TO 30%.
To ceanna's example, a 30% increase would take a 10% risk up to 13.3%. This is consistent with what you've read from me on the board, based on the various studies I've seen.
To be picky on the numbers based on what the studies actually show, the math has to be a backwards calculation, starting with the risk level before the benefit of the risk reduction is applied. Therefore if your risk is 10% without Tamoxifen, and Tamoxifen is known to reduce risk by 30%, then your risk without Tamoxifen is 14.2%. Here's the math (with a little bit of rounding to stay within 1 decimal place):
Risk without Tamoxifen: 14.2%
30% of 14.2: 4.2 - risk reduction from Tamoxifen
14.2 - 4.2 = 10% risk if you take Tamoxifen
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Nevermind me. I did it wrong.
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WC3, the only error is a slight mathematical one.
A 30% decrease or reduction is calculated by applying the 30% to the higher number. i.e. the number that is being decreased by 30%.
Therefore, if Tamoxifen reduces the risk of mets by 30%, it works like this:
- If the risk of mets without Tamoxifen is 10%, then with Tamoxifen, it's 7%, which is a 30% reduction of the 10%. 10 - 7 = 3, 3 is 30% of 10
- If the risk of mets when taking is Tamoxifen is 10%, then without Tamoxifen, it's 14.2%, because 10% is a 30% reduction of 14.2%. 14.2 - 10 = 4.2, 4.2 is 30% of 14.2
On the other hand, if a condition or activity increases risk, the increase is calculated by applying the % increase to the lower number, i.e. the number that is being increased.
I think we are getting too much in the weeds.
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Thank you!!!!
Thank you so much Beesie and WC3. Makes perfect sense
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I agree with Beesie. One thing I do understand is the math and stats.
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fantastic. Thank you Meow13.
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Beesie:
Thanks for the correction! My brain is a bit rusty.
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mom2bunky:
Disregard my second calculation. I did it wrong. I'm doped up on oxycodone and steroids because of surgery.
I should not have done math under the influence.
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Feel better soon WC3...
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mom2bunky:
Thank you!
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