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Jan 9, 2018 02:37PM
jo, Sorry you find yourself here. The oncotype is used in cancers that are ER positive and HER2 negative. In those cases, it helps to determine the percentage of benefit of chemotherapy to help in the decision making. If the cancer is ER negative and/or HER2 positive, then chemo is usually recommended, which is why oncotype is not done in those cases.
As far as lumpectomy versus, mastectomy, it is a very individual decision. If there are 2 tumors, it may depend if they are close together. Mastectomy and lumpectomy have the same overall survival rates. Lumpectomy has higher rates of local recurrence. Mastectomy has a higher rate of complications. The situation is very individual and there is no right/wrong for any person. I had a bilateral mastectomy. My decision was made based on the following:
1. I had a very strong breast cancer background in my family, and I was pretty young (43) at diagnosis. If I had less chance of local recurrence, that was important to me. Notice I said less chance, not no chance, As you can see, I did have a local recurrence. It can still happen.
2. I had size A breasts. Tiny. If you were taking the lump, you were pretty much taking the whole thing. They would have had to put an implant in that breast (and the other) which would have obscured future imaging...a problem given my high risk.
3. I chose bilateral because my tiny saggy breast would look ridiculous next to a perky implant. I would have had to have an implant in both. As long as I required surgery anyway, I wanted to get rid of the breast tissue. My mom had a new primary in her other breast 20 years after her first round, I wanted to minimize this possibility. Again, it's rare, but I have a strong family history.
There were other reasons, but that's pretty much the gist of it for me. Had I had nice big breasts where a lumpectomy would suffice, I might have made a different decision...not sure since I was not in that category.
Good luck with your decision. Make a pro/con list of all of the choices, and bring a list of questions with you. Also bring a partner/spouse/friend with you to take notes. You won't remember anything the doctor said a few hours after you leave. :)
8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC)
8/26/2013 Mastectomy: Left, Right
9/20/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
12/12/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
1/23/2014 Reconstruction (left); Reconstruction (right)
1/29/2015 Lumpectomy: Right
2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH)
2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC)
2/25/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal
3/31/2015 AC + T (Taxol)
8/25/2015 Whole-breast: Breast, Lymph nodes, Chest wall