Mar 15, 2021 09:16PM moth wrote:
Hi & welcome to the boards. I'm sorry you find yourself dealing with this diagnosis and such a difficult decision.
I didn't have to make your decision as chemo was a given for me right from the start but I wanted to give you some things to mull over:
As I understand the TailorX study results, for <50 year olds, if recurrence score was 0-15 there was no benefit to chemo; recurrence score 16-20 has ~1.6% benefit; 21-25 has ~6.5% benefit. (this is from the TailorX study which studies intermediate results. Reported out in 2019. You can see the under 50 yo subset analysis here https://www.oncotypeiq.com/en-US/announcements/TAI... towards the bottom hit a grey bar near right side which says "...may differ for younger patients =<50"
soooooo. all this to say, at 20, there is some benefit, though whether it's 'worth' it is a good question.
Several things I'd consider:
-your race. Oncotype may be less accurate for black patients https://www.cancer.gov/news-events/cancer-currents...
-how strongly ER+/PR+ was your tumor? If it's very strong, that's a better predictor of tamoxifen being an effective therapy
-what Grade? Grade is a proxy for the speed of the tumor growth & to an extent, its aggressiveness. High grade tends to be more dangerous but also tends to respond better to chemo
-how likely are you to put up with the possibly very unpleasant side effects of Tamoxifen? Only you know your tolerance for suddenly feeling like a creaky old lady, or loss of libido, or vaginal atrophy or mental fog etc etc etc. Which is not to scare you off hormone therapy but to be honest about the fact that while for many, it's a tolerable treatment with minor side effects, the reality is also that many women do NOT stay on these meds for the length of time recommended (5-10 years)
-otoh - if you have some issues like neuropathy or just feeling aged by a decade after chemo which might not have been necessary, will you regret that or will you think it was worth it for the extra guarantee?
-your personal risk personality & feelings of regret. Do you want to be able to say 'I did everything' or are you ok with saying 'I did what I thought was right & reasonable & I'm ok with how things play out'
Whatever you decide, you want to get to a place of having no regrets, kwim?
Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the OddsDx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- Surgery 12/12/2017 Lumpectomy; Lumpectomy (Left); Lymph node removal Chemotherapy 2/13/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole breast: Breast Dx 2/2020, IDC, Left, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/18/2020 Tecentriq (atezolizumab) Chemotherapy 11/25/2020 Abraxane (albumin-bound or nab-paclitaxel) Radiation Therapy 12/8/2020 External Hormonal Therapy 12/15/2020 Femara (letrozole) Radiation Therapy 3/2/2021 External Local Metastases 3/2/2021 Radiation therapy: Bone Targeted Therapy 1/1/2022 Trodelvy (sacituzumab govitecan-hziy)