Here's the TAILORx study results:

Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer

https://www.nejm.org/doi/full/10.1056/NEJMoa1804710

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The chart that I included above is in the Supplementary Appendix, Figure S8.

Sshibal - Beesie has given you some really good information to work with. I would not hesitate to obtain a second opinion just because you are at one of the best centers. I believe in trusting your medical team but also to be educated and aware of your options. When the rubber hits the road, it's your body and your health and your future health. If I am not intruding, where are you being treated?

I will update with my score as soon as I get it. The wait is driving me crazy!

Beesie - thank you again for this information. I have tagged this for when I have my next MO appointment (whenever the heck that will be!)

only girl, tailorx is for node negative. The node positive swog study has much less data and is older postmenopausal women. Make sure they give you the right results. I got both reports because they submitted me as node negative first. There is an ongoing trial that won't be completed for several years. Node negative will show numerical results. Node positive reports will not due to lack of sufficient data. It just says “no apparent benefit". My oncotype was 15. I went for 3 opinions because I didn't want to look back with regret. I know you like your dr but I had 2 top docs, one at nci center and other at Sloan with opposite opinions. Sloan said yes do the chemo. But recommended cmf because I was in the gray area and it had less permanent side effects. Sloan also recommended ovarian suppression and AIs over tamoxifen. I also had extra nodal extension.Sorry it's a bad time for you to see drs. And your fills are getting delayed. I start radiation Monday but I think they will delay my ovary removal.

I think oncotype can be predicted mostly based on estrogen progesterone % ki67 and miotic score. But ignores node status, lvi and ee. I am a skeptic regarding oncotype for node positive and the Sloan dr confirmed all my thoughts.

JRNJ - Thanks for all of that info. It is very helpful. I will definitely be having more conversations with my MO. Until I get my score, it's hard to think, contemplate or know what direction to take. I feel like my life has been on hold for the past 4 weeks with no end in sight! I am anxious to move to whatever the next step will be.

How did the CMF go? I see in your Dx info that you started in early December.

only girl, yes first step is getting your oncotype score. You are highly er/pr positive. Do you know your ki67 and miotic score? If oncotype under 11 no chemo. Between 11 and 18 is gray area for node positive. But maybe make a dr appointment for second opinion now as it might take time to get one. I waited but was lucky got in quick with both Rutgers and Sloan. My goal was to be aggressive, I didn’t want to regret doing too little. I finished cmf 3/10. Yaa!! I had 8 treatments every other week. TC would have been 4 every other week. Cmf appears to be a Sloan only thing, not too many people doing it. Less side effects and risk of permanent side effects but still annoying. Luckily I was able to take leave from work. First week felt crummy especially day 3 and 4 more from Neulasta than chemo. Second week I was in pretty good shape. Functional and doing house projects most of the time. No nausea, but acid reflux and fatigue and chemo brain and severe sweating attacks. after 2 periods on chemo it put me into menopause. Lost 90% of hair but still have some, better than losing it all. My taste buds are shot and slowly returning. I recently have hand and arm pain at night but cmf not supposed to cause neuropathy like taxol. Might be lymphedema. I've been painting my house this week and I tend to over do it. I consider it a blip in time and it's over. But some people do have more serious side effects. No regrets doing chemo. I have anxiety that I should have done the stonger chemo or should have had more nodes removed. Glad I'm doing radiation but hope it goes ok.

Sshibal, I am not really sure if it's common more common for younger women, but local recurrences can definitely happen. My situation was a bit unique maybe, because my "local recurrence" was probably caused by the biopsy needle dragging cancer cells into my skin/fat tissue. Some doctors thought it was more of a "persistence" than a true recurrence, but we can never know for sure. They treat it as a recurrence. In any case, the cancer started to spread out across my skin very rapidly once it got there, so it did cause a lot of trouble.

MD Anderson did a small study on needle seeding from biopsies, and it is rare, but my cancer fit the description for people who are at risk of having this problem. My cancer was very aggressive and fast growing. As I mentioned my oncotype was 32, but my Ki67 was something like 89%... just ridiculously high. Here's the link to that study: https://link.springer.com/article/10.1007/s10549-0...

Getting breast cancer is never what any of us wanted, but it seems like you are in a good situation under the circumstances. It's good that you are at a top cancer hospital to start out with - I didn't start out at one, but I am at one now. It makes a big difference, in my opinion.

Hi Sshibal, I am almost in the exact same position as you. Diagnosed a few weeks before my 35th birthday, Stage IB, Grade 3, Oncotype 17, but I also have micrometastasis in my sentinel node (.6mm). My MO told me I am in a grey area (due to high-ish clinical risk & age, but low-ish oncotype score) and so she's going to reach out to a friend of hers who is an expert in BC in younger women to get her opinion.

Right now she is recommending radiation, tamoxifen, and ovarian suppression (same as yours I think). She also said that the chemo benefit in pre-menopausal women is thought to be from the ovarian suppression side effect which is why she is recommending suppression over chemo.

I don't want to go through chemo if I don't have to, but I was hoping my results would be clear and I wouldn't feel like I have to make the decision. Good luck with your treatment, keep us updated on what you decide!

Interesting stuff! I am 43, node positive (8mm in node, no extension) and oncotype score of 10. I see the oncologist on Thursday.

Very scary for me not to do chemo. Not a ton of data for node positive premenopausal, but nonetheless I have a low score. 94% Estrogen 88% Progesterone.

Thinking ovarian suppression and Anti hormone pill?? Anyone in a similar situation?? Thoughts on possible treatment??