Chemo??

It's not the Oncotype score that you have to consider, it's what the Oncotype score means in terms of metastatic risk and the benefit of chemo.

With your 21 score, has your MO told you your risk of a metastatic recurrence with Tamoxifen alone, versus what it would be with chemo and Tamoxifen? Is the risk level with Tamoxifen alone too high for your risk tolerance? Is the risk reduction you get from chemo large enough that it's worth it to you?

This is the chart that I pulled from the TAILORx study, which I believe is now being used by Genomic Health to determine Oncotype risk levels for each score, but you should definitely verify this info with your MO, if you haven't already been provided with this data.

Hi Lengl11, I’m 46 and also had an oncoscore of 21. I decided no chemo for a potential benefit of only 3-4%. Not worth the toxicity of chemo, in my opinion.

I was dx with IDC at the end of May. I had a lumpectomy at the end of June. Final pathology report showed stage 1b, grade 1, ER+, tumor was 2.8cm and 1 out of 4 lymph nodes came back positive with 4mm of cancer. My oncologist wants me to do 6 chemo treatments, 1 every 3 weeks, then radiation and then hormone therapy. When he told me this, I told him that I did not think I wanted to do chemo. He suggested the oncotype test. He said that the decision was mine, but he wanted to make sure that I have all of the info before I make a final decision. My results are in and I go in to get them Friday, but I can already tell you, I have already decided that I will not do chemo, regardless of what the score is. I just do not think that all of the possible side effects and the guaranteed side effects of chemo are worth the small percentage change in the chance of recurrence. That is my own personal decision after doing a lot of research, speaking with my husband and lots of prayer. I will continue on with my original plan of radiation and then hormone therapy. I am also going to do as much as I can on my own with weight management, exercise, diet and supplements. Now, like I said, this is my own decision for me. That is what everyone has to so. Make a decision that they feel is best for them.

Everyone is different and responds to all of these treatments differently. I saw a lady on here the other day that was diagnosed with almost the exact same BC as me. She had a lumpectomy, did chemo, did radiation and was doing the hormone therapy when 3 years after her original diagnosis she was diagnosed with a new IDC. So once again, she did lumpectomy, chemo, and radiation and has just recently been diagnosed with stage iv metastatic BC. My point with this story is that she went through the agony of chemo twice just to have it come back and then worse. Not to sound like a downer, but my thoughts are, if it is going to come back, it is going to come back and I do not believe that chemo is a huge deciding factor in that. So, if I do not do chemo now and my cancer comes back, I will tackle it then and make new decisions then based on what I know at that time. As for now, my decision is no chemo.

I pray that everyone makes the best decisions for themselves and that there is no judgment from others for your decisions. They are our bodies and we have the right to make the decisions that we are comfortable with. My prayers are with you all!!!!

Hopeful, excellent points. Yes, Lengl11 needs to speak to her Oncologist to get the risk figures and chemo benefit that is specific to her situation.

Also, table 2 from the June 20, 2019 TAILORx article shows how clinical risk changes those scores for 9 year distant recurrence.

If you are under 50, and have an intermediate Oncotype score of 21, your risk of recurrence with tamoxifen alone is either 11.4%( low clinical risk) or 18.8% (high clinical risk).

You reduce your risk in these amounts by adding chemo: 6.4% and 8.7% respectively.

The challenge is that the experts feel that the cytotoxicity of chemo is not the cause of the improvement, instead it is the ovarian suppression caused by chemo. They have a reasonable argument for this, but in my opinion it is just a great theory derived from study results. It is not proven, yet.

In my case, I feel like in 5 or 10 years there will be a study and I'll either be happy I did chemo or kicking myself.

hello sweetie everyone s different I've been on here long long time encouraging others. I worked in medical field almost entire adult life my fiance were making wedding plans for our 2nd marriages I was 42 and had prayed for this man then I find lump in breast no pain just little sore round nipple also sore under my left arm also. Well after biopsy was diagnosed with breast cancer. Had my cry then decided to fight with better diet faith and Positive thoughts. Had 3mo chemo before after Lmast idc stage 2 0/3 nodes we got married still bald I love this man he got down on one knee while I just finished throwing up to propose. then rads 7wks then tamoxifen. Praise God I am now 25yr Survivor..msphil

Reach out to the chemo forum, you'll get all kinds of support. You'll get through this! HUGS