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May 29, 2010 04:09PM
How old are you? Perhaps you're younger than I was, as the only other "main" difference would be that your tumor was considered grade 2, whereas mine was allegedly grade 1... The first oncologist I saw, prior to having the surgery and switching to an onco affiliated with the "breast center" where the breast surgeon I chose was based, had a different plan entirely. He didn't even mention the Oncotype DX test, and in his world the only things that mattered were tumor size and nodes involved. We'd discussed that if it was over 2 cm (the MRI suggested it was, and the ultrasound suggested much smaller), I would definitely end up with chemo. Not only that, but afterward he wanted to do both Tamoxifen AND Lupron shots to knock out my ovaries.
The other oncologist I met with after the surgery. It was primarily the Oncotype score that she used: she said that the negative impact of the side effects and possible long term damage from the chemo compared to the relatively low benefit I'd likely see from it made it not worth it in my situation. I think having a HIGHLY ER and PR positive tumor played into it - my tumor had Tamoxifen written all over it.
So perhaps you're less ER/PR positive? Or younger? It could also just be the way your oncologist operates. None of this appears to be an exact science, sadly. That's been one of the most horrifying things to me - how different the approaches can be. You end up having to do a lot of reading and then really almost "picking" your plan. Like with my surgery - I had a lumpectomy but no one would have batted an eye if I'd chosen a bilateral. Mind-blowing.
I didn't have any discussions with the kind of super-specific percentages your onc appears to be giving you. I think if it was calculated out, my benefit from Tamoxifen is probabaly not that huge either. The theory seems to be that it's more likely to come back to haunt me about 10 or 15 years out, due to how it grew the 1st time...
I'm just about two years out from diagnosis, and still feeling good about my choice of surgery, my lack of chemo, and my prognosis.
Please do consider talking with another oncologist. I think that with the variations in options, the MOST important thing is that you believe in the oncologist and the plan makes sense to you. You should feel a sense of "we are doing what we should be doing to keep this from popping up somewhere else."
6/19/2008, ILC, 2cm, Grade 1, 0/2 nodes, ER+/PR+, HER2-