Low Oncotype, node-positive and chemo decision
Hi all, I've been lurking since my diagnosis in August but this is my first post because I'm really struggling to make a treatment decision in the next few days. In brief: I am 47 years old and premenopausal. I had a 1.2cm stage IIA tumor, highly ER/PR positive, HER2-negative, low ki-67(1-5%), grade 1. It was removed via lumpectomy September 18 with clear margins. Although the nodes were clinically negative, the pathology report was positive in 2 of 3 lymph nodes (macromets of 2.1mm and 3.2mm).
However, because my Oncotype score was 15, I've had different recommendations from two oncologists. The first one wants me to have 4 rounds of Taxotere/Cytoxan. The second--head of breast oncology at a major research hospital--said he wouldn't even know what to advise his own wife in my situation because the data isn't back from current studies. He left the decision to me, but said he prefers Taxol/Cytoxan and would give it on the same schedule (4 rounds, 3 weeks apart). I'm completely overwhelmed, single and don't have a lot of family support, so I'm basically alone in making every decision. What makes the decision even more difficult is that I posted a question on the Johns Hopkins board and they basically said that although they couldn't provide a consultation, chemo isn't generally recommended with Oncotype 15 scores.
My biggest fears at this point are permanent hair loss and debilitating neuropathy, since I make my living as a writer. I'm definitely leaning toward chemo but am wondering if others out there in my situation routinely skip it. Also, I'm wondering if the Taxol/Cytoxan regimen might be a little easier. I know it's not as commonly prescribed. Adding another complicated twist to the mix is the fact that the research hospital that uses the Taxol-based regimen does not offer freezers or cold caps, while the Taxotere-based one does provide both Dignicaps and freezer access. It's also geographically closer. Anyway, sorry this is so long-winded! ANY advice, insight or general opinions would be greatly welcomed. Have a nice weekend everyone.