Diagnosed 1 mnth+ ago, deciding on treatment
Hi ladies! Been lurking here since i got birad5 on my ultrasound, this's my 1st post.
I had a single mastectomy on my right breast. Final pathology showed idc 2.2mm with dcis, grade1, ki67 5-7%. Er/pr+, her2- (fish and oncotype dx confirmed), no lymph node/vascular involvement 0/6. My oncotype score is 11, 3% recurrence in 9 years, less than 1% benefit of chemo.
In the onctype chart, the Confidence interval varies between 1-7%. does this mean the risk can go up and down even if it stated 3%?
I have not discussed this with my onco as i just got my oncotype dx today.
I'm 42 years old and been doing research on the hormonal therapy drugs. I read that femara/arimidex is superior to tamoxifen? Should i ask for arimidex and get ovary supression/removal?
Also, is it better to ask the onco to give me radiation as i don't want to be undertreated.
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Hi @mollybocil, Sorry that you have to join us here. The information provided by the oncotype is based on statistics which looks at the rate of recurrence for a large population. It can't predict what will happen to you but gives an indication of the likelihood. It is reported in percentages which makes imagining a room of 100 women an easy way of understanding the data. In your case 3 people in the room would have a recurrence in 9 years. There would be no way of knowing if you would be one of the three. I like to look at it backwards and say that 97 of the women in the room would not have a recurence since it is a more positive interpretation of the data. The confidence interval is a statistical measure of the range of values used to calculate a population mean (average). 1 - 7 % tells you that the recurrence number could actually be anywere between 1 to 7 people if your particular room of 100 people were followed for your lifetimes.
Since you had a mastectomy and no nodal involvement there is no benefit for radiation. Both radiation and chemo are toxic to kill the cancer cells but can cause lasting side effects like neuropathy. These treatments are only done when the benefit outweighs those risks. As someone with permanent radiation side effects I can attest to that.
Statistically (not an assurance for you) aromatase inhibitors reduce the risk of recurrence by 50% while tamoxifen reduces it by 40%. For a recurrence percentage of 6% AIs would make the risk of recurrence 3% while tamoxifen would make it 3.6%, not much of a difference. I personally can't attest to ovary supperession/removal but from what I have read on this site it can be difficult to live with. You can read up on that by using the search bar at the top of the page.
Positive lifestyle changes or continuing your healthy lifestyle can also reduce the risk of recurrence by 50%. A healthy diet, aiming for a normal BMI, avoiding alcohol and exercising at least 150 minutes a week are recommended to get this benefit.
Unfortunately there is no guarantee that the cancer will not recur but your numbers make it unlikely. I hope your appointment with your onco goes well.
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Hi @maggie15 thank you for the explanation! And i'm so sorry that you have side effect from the radiation
There's a dna test called CYP2D6 that will tell the effectiveness of tamoxifen on you. I'm planning to take that test too.
I will discuss this with my oncologist later.
I had anxiety disorder before my diagnosis, now my anxiety is getting out of hand 😢 i'm currently on escitalopram to ease my depression
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