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Topic: Oncotype DX score of 26 - chemo or no chemo?

Forum: Stage I Breast Cancer — Meet other members with a Stage I breast cancer diagnosis to share information and support.

Posted on: Aug 28, 2016 07:11PM

Sunset860 wrote:

My Oncotype DX test score came back as a 26 and I am having the hardest decision on what to do about chemo- My MO said it my decision as score fell in the intermediate range. When I asked for her opinion, she said she has gotten more conservative with her recommendations as she has gotten older and if I was 39 she would say yes do chemo, but at my age 59, she didn't think the chemo side effects out weighed the reoccurrence risk. Just don't know what to do, am afraid of chemo as I have many issues with allergic reactions to chemicals and even had anreaction to thedye used for the sentinel node procedure. Any thoughts would be appreciated

Dx 6/28/2016, DCIS/IDC, Left, 2cm, Stage IA, Grade 3, 0/1 nodes, ER+/PR+, HER2-
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Aug 28, 2016 08:00PM - edited Aug 28, 2016 08:01PM by Luckynumber47

If ou want it in black and white, ask to have them do a Mammaprint test. There is only high or low - no in between.

Before Oncotype the oncologists looked at tumor characteristics to determine if chemo was necessary. Things like tumor make-up (mine is IDC), Mitotic rate (how fast your tumor divides, lower is better) stage (basically how big your tumor is and whether nodes are involved) grade (is this an aggressive tumor or slow growing) ki67 - another indicator of how fast the tumor grows, and whether you are ER/PR positive. Since your oncologist felt comfortable letting you skip chemo I'm guessing all of those indicators are in your favor.

My understanding of AIs (if you are ER/PR positive) is that they offer a much higher percentage of protection than chemo with limited side effects. Now if we just had the crystal ball.........

My avatar is a Blue Footed Boobie. Cracked me up. Dx 2/15/2016, IDC, Left, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- Dx 3/16/2016, DCIS, Right, <1cm, Stage 0, Grade 3, 0/1 nodes, ER-/PR- Surgery 4/5/2016 Mastectomy: Left, Right Hormonal Therapy 5/16/2016 Femara (letrozole)
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Aug 29, 2016 07:43PM KBeee wrote:

Getting a second and third opinion and possibly the mammoprint will help you decide. It's hard when there are no easy answers

Karen. Dx 8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 8/25/2013 Mastectomy: Left, Right Chemotherapy 9/19/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/11/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/22/2014 Reconstruction (left); Reconstruction (right) Surgery 1/28/2015 Lumpectomy: Right Dx 2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH) Surgery 2/24/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal Dx 2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC) Chemotherapy 3/30/2015 AC + T (Taxol) Radiation Therapy 8/24/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Femara (letrozole)
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Sep 1, 2016 01:28PM Sunset860 wrote:

Thank you. Decided to go for a second opinion. Appt. is tomorrow

Dx 6/28/2016, DCIS/IDC, Left, 2cm, Stage IA, Grade 3, 0/1 nodes, ER+/PR+, HER2-
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Mar 10, 2018 11:19AM smiletxstyle wrote:

Interested to know your decision and how you’re doing now. Almost identical situation with a score of 26, just slightly younger, almost 54. Oncologist & surgeon both agree, professionally, either choice will be right. With a 87% chance of no reoccurrence (which my gut says i’m already there!) not sure the side effects of all the chemo toxins makes sense for 4% pts - tatistically, that’s a rounding error. Leaning towards SAVI radiation and incorporating a healthy diet, holistic benefits daily and removing toxin with an amazingly positive attitude to live life to the fullest every day.

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Mar 10, 2018 11:53AM - edited Mar 10, 2018 11:54AM by Meow13

I was 53 at dx, I had two 1cm tumors one ilc and one idc, my oncodx came back 34. I had no nodes involved I was 95% er+ and pr negative. I did a mastectomy and diep reconstruction. I chose no chemo and did 4 years AI drugs. On my 7th year no cancer.

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May 20, 2018 06:05PM - edited May 20, 2018 06:22PM by Marymc86

I'm also interested in her reply. I had oncotype test, scored 27. I don't want chemo or hormone therapy. Side effects scare me. 36% chance of recurrence if I do neither. No node involvement, clear borders at lumpectomy, breast reduction tissue also clear. I want to take my chances. Having second thoughts. Diagnosed February 12, 2018. IDC, 1.3cm 0/3 nodes. New member of this site.

Dx 2/12/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Radiation Therapy 6/25/2018
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May 20, 2018 06:06PM - edited May 20, 2018 06:07PM by Marymc86

This Post was deleted by Marymc86.
Dx 2/12/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Radiation Therapy 6/25/2018
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May 20, 2018 06:23PM Meow13 wrote:

Marymc86, you could just leave it at that. I think getting follow up scans, mri and mammograms on a regular basis is a good way to go. I didn't pursue additional hormone therapy after the 4 years I took it. Still have residual side effects but nothing earth shattering. If I could go back I am not sure what I would do. There is no way to tell if AI drugs were effective.

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May 22, 2018 01:18AM Marymc86 wrote:

I appreciate the response, Meow13. Scans? No one has recommended anything except the usual follow up mammograms.

I think I will take my chances and hope I don't regret it later.

Dx 2/12/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Radiation Therapy 6/25/2018
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May 22, 2018 01:25AM Meow13 wrote:

I have one mammogram a year and one breast mri each year. I have extremely dense tissue. My oncologist is very quick to schedule mris for pain. I hurt my back and got an mri to check for cancer. Also tinnitus doctor said get a sinus mri. My doctor believes in mris.

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Jul 6, 2018 04:57PM Aprilbud wrote:

So glad that I found this discussion board. Just got back from the onc today. My score was 37. With a 10 year recurrence of 25%. I had made up my mind from the beginning that I would not do chemo. Only hormone Therapy. My bc surgeon said from the get go that I would not need rads or chemo and I am leaning that way. I am 62. If I live another 7-10 years with no recurrence I am ok with that. Someone tell me that I am not crazy?

Diag 4/17/2018. IDC stage 1a. Mastectomy 5/30/2018. Nodes negative ER+ PR+ HER2

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Jul 6, 2018 05:19PM - edited Jul 6, 2018 05:19PM by Meow13

Aprilbud you are not crazy at all. I had a score of 34 and in retrospect I am soo happy I didn't do chemo. If I had it to do over not sure if I would have done AI drugs.

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Jul 6, 2018 05:44PM Moderators wrote:

Aprilbud, welcome to our community. Every decision is so personal, so no, you are not crazy. You need to decide what makes sense to you, your life. Medicating

To send a Private Message to the Mods: community.breastcancer.org/mem...
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Jul 8, 2018 12:28PM Aprilbud wrote:

Thanks Meow. I am still leaning towards no chemo. Just doing AI for the next 5 years. I can’t worry about what may or may not happen in 10 years. I am living for today. Happy that my bc surgery is over. Looking forward to getting fitted for my prosthetic next week. I will worry about the future when it gets here.

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Jul 9, 2018 11:04PM - edited Jul 9, 2018 11:08PM by Marymc86

Apribud, I do not think you are crazy. I skipped chemo and my oncologists were clear they wanted me to do it. I'm also considering skipping out on Tamoxifen, too. I'm doing radiation now and, so far, it's going well. Halfway through it. I'll have to tackle the drug therapy issue next. I suppose I'll cave and try it, but I really don't want to.

I hope I don't regret skipping chemo later. I've had moments when I thought I was crazy, but I think I can live with my decision even if it does recur. So many stories of people who did opt for chemo and still had a recurrence. I think I would have done it if I had been HER2+ .


Dx 2/12/2018, IDC, Right, 1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Radiation Therapy 6/25/2018

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