Two Hospitals Provided fully two different treatments, I can not believe that
I was diagnosed Breast Cancer , ER+ 90, PR-, KI67-30% Tumor 1.8cm, her2 negative, ALAND lymph notes 3/6 positive found from surgery. stage 2, I have done surgery 07/30/2025. Oncotype score 14, UT Southwester Hospital provided the treatment with T 12 time once a week, and AC 4 times, every two weeks. Radiation 30 days. I went to the MD Anderson, the Dr provided the treatments with No chemo, AI (7-10 years)+CDK 4/6 Inhibitor (2years). Radiation 14 times I was confused that why the two treatments are totally different and it is hard for me to make the decision. Does anyone has the same conditions? please sharing
Comments
-
Hi @bettereveryday13, Have you asked the doctor at each hospital the rationale for their proposed treatment plan? If they explained the benefits and possible side effects of their proposals it might help you decide. You should mention the quite different treatment recommendations as a reason for trying to get more information.
I'm not a medical professional but from what I can figure MD Anderson's plan is taking into account your Oncotype of 14. This lower score indicates that chemo might not be very effective (the cancer cells may be dividing slowly) so they have proposed a two year course of a CDK4/6i instead. An AI for seven to ten years would be standard with three positive nodes.
Before the Oncotype was available having 3 positive nodes would mean a chemo recommendation. UTSW seems to be following a somewhat older protocol. The radiation period is longer but there is no information about the total dose so it's hard to compare those treatments. A shorter length of treatment time with slightly higher doses is where radiation treatment has been heading. I'm guessing UTSW would also have you take an AI afterwards even though it's not mentioned.
Both hospitals are considered good but MDA is the second ranked cancer hospital internationally. It might be worthwhile getting a third opinion remotely from another well known cancer center like Dana Farber or Memorial Sloan Kettering where you present them with the two different plans and ask which one they think would be most effective.
In this situation you need more input from oncologists. All the best making your decision.
1 -
Hi, maggie15, thanks for the explanations. What MD Anderson explained was that Chemotherapy has a <1% benefit of -2.2% of side effects, which is the benefits less than the side effects according to the Oncotype interpretation. I consulted with the third doctor, who said she is used to the Mammaprint report, and she ordered the Mammaprint and told me that if the Mammaprint report is low risk, she agrees with the MD Anderson; if it is moderate, then she will consider 4-time TC treatments. If it comes a high risk of recurrence, then she agrees with the UT Southwestern treatment plan. For the radiation treatment, yes. Both hospitals are recommended.
0 -
@bettereveryday13, I’m glad you got further information. The effectiveness of chemo is the key. The Mammaprint should help guide your decision. I hope your treatment goes well.
0
