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Jul 31, 2018 04:39AM
Well, I met with my MO yesterday and her explanation of the seemingly disparate results is that my cancer is heterogeneous. So parts are ER+ and parts are TN. So treat for both. She did not think any additional testing was worthwhile. She was also totally unapologetic over the fact that she hadn't thought the Oncotype DX report was worth doing at all...not a feel good moment.
Her assessment of recurrence risk was that the actual curves and figures in the Oncotype DX report are NOT valid for me, as my report showed ER negative. But she also thought my risk of recurrence was at least as high as the report indicated (like 32% in ten years) and that chemo would definitely be of benefit. But she said there are no good databases or studies on heterogeneous tumors, so no real way to quantify the likely reduction in recurrence risk. So it's all a crap shoot.
She's recommending taxotere + cytoxan for 4 cycles rather than AC+T on the grounds that the tumor was small (<2cm), the margins were very good, the sentinel lymph node was negative. Had any of those factors been different, she would have recommended AC+T.
She wants me to start NOW...as I am already 5 weeks post surgery. I kind of want a second opinion but cannot get any appointments that fast. Yuck. For what it is worth, she said AC is pretty well tolerated and many/most pts are able to keep working, are only out of commission maybe 2-3 days per cycle. Let's hope so!!!
The other weird news was that she took me off arimidex as I have osteoporosis...only no one ever told me I had osteoporosis...including my GP who ordered the DEXA scan as part of a routine physical back in February. So that's one more thing to follow up on.
So I am wrapping my head around all this today.
I guess I'll go sign up for the August Chemo group...it is really wonderful to be part of this community!
10/24/2013, DCIS, 1cm, Stage 0, Grade 3, ER+/PR-
10/24/2013 Lumpectomy: Left
5/22/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR-, HER2- (IHC)
6/27/2018 Lumpectomy: Right; Lymph node removal: Right, Sentinel; Mastectomy: Left
11/20/2018 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)