Log in to post a reply
Sep 10, 2021 04:35PM
Has your doctor run the RSClin score? That takes the oncotype, your age, the grade of the tumor & the size of the tumor and recalculates risk. Beesie talked about in this post https://community.breastcancer.org/forum/85/topics...
I would ask the dr to run that if they haven't.
But here's my 0.02 without the RSClin
based on: age, grade & the weak PR, I would lean heavily to chemo. But full disclosure, I almost always lean to chemo. Someone has to really convince me chemo is a net likely harm and I just don't see it here. Weak and neg PR has its own issues which we don't really understand but these cancers can be driven by things other than hormone.
If you're not feeling able to make this decision, I'd reach out for a second opinion, esp with an oncologist who deals with cancer in young women.
You only get one kick at this. There is only one opportunity to wipe out any stray cells.
You can see some of the numbers from TailorX here: https://ascopost.com/issues/august-10-2018/how-to-...
See Table 3: 9 year distant recurrence free goes from 86.9 to 93.4 with the addition of chemo to endocrine therapy.
I'm not sure where your doctor got their numbers from because they do not seem to match TailorX?
One other thing you might want to look at is just forgetting about Oncotype....when it wasn't available, just a few years ago, we used large data sets to estimate benefits of various therapies. You can enter your stats into predict and see how it plays out (you'd likely be getting 3rd gen chemo so click that box btw) https://breast.predict.nhs.uk/tool
Difficult decision for sure. One last thing: how will "future you" feel? Are you more likely to regret negative side effects from chemo which might not be necessary or are you more likely to be really regretful of not having done chemo if worse comes to worst and you recur? I threw everything I could at it & still recurred but for me that was important - I have no regrets, I did *everything* I could. ... I hope you come to a decision you feel comfortable with. It sucks when it feels like we're stuck making decisions which really we're not trained for and yet, they fall to us...
I take weekends off
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 Odds
12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC)
12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel
2/14/2018 AC + T (Taxol)
8/13/2018 Whole-breast: Breast
2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2-
3/18/2020 Taxol (paclitaxel)
3/19/2020 Tecentriq (atezolizumab)
11/26/2020 Abraxane (albumin-bound or nab-paclitaxel)
12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, ER+/PR-, HER2- (IHC)
12/16/2020 Femara (letrozole)
1/28/2021, IDC, Left, Stage IV, metastasized to bone
3/3/2021 External: Bone