Topic: Treatment “grey area”

Forum: IDC (Invasive Ductal Carcinoma) — Just diagnosed, in treatment, or finished treatment for IDC.

Posted on: Feb 18, 2022 02:48AM - edited Feb 18, 2022 02:48AM by odyssey305

Posted on: Feb 18, 2022 02:48AM - edited Feb 18, 2022 02:48AM by odyssey305

odyssey305 wrote:

Hi everyone. I'm confused about a treatment meeting with my MO today and am curious about similar experiences. At the appointment we went over my Oncotype report, and apparently my scores put me in the grey zone for treatment options. So for reference, I'm 49 and premenopausal. My Oncotype score was 17 but it showed no benefit to chemo. My 9 year recurrence risk is 15%, assuming endocrine therapy. My MO called this “not great" but could be worse. She also said that other doctors could easily make a case for pushing forward with chemo, but she feels that chemo isn't worth the potential SE since there is no clear benefit to survival. So the plan as of now is start on Lupron while I wait for a surgical consult for an oopherectomy, then Femara and radiation.

Has anyone had an intermediate Oncotype score that didn't recommend chemo but chose chemo anyway? If so, what were some of the deciding factors? Also, I'm not thinking about a second opinion right now but what about a tumor board review? Has anyone requested that? Thank you so much for reading this and being willing to share!

Dx 12/2021, IDC, Right, 1cm, Stage IB, Grade 1, 1/5 nodes, ER+/PR+, HER2-, FISHISHCISH
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Feb 18, 2022 09:54AM gb2115 wrote:

Mine was 19. They gave me the choice initially but after talking through it at the appointment the MO changed her mind to recommending it. That said, I had a node positive recurrence on tamoxifen, so not sure the Oncotype research really applies to someone like me. One of my doctors (RO) said the research is based on first cancers, not recurrences.



First Dx IDC in 10/16 at age 38, stage 2A, 1.2 cm ER/PR+ Her2-, Grade 2, 1/3 nodes. Lumpectomy + radiation + tamoxifen. Second Dx IDC recurrence in original location 5/21. 1.3 cm ER/PR+, Her2 -. Grade 2. 2/2 nodes. UMX + AC/T + Zoladex/Exemestane + Zometa.
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Feb 18, 2022 12:18PM odyssey305 wrote:

gb2115 thank you for sharing that. When I first got my path report I was relieved that I had dodged chemo, but that shifted to dread once I realize I have to rely solely on hormone therapy. I went down the rabbit hole last night looking at research on benefits of chemo with intermediate Oncotype scores and apparently chemo does slightly reduce recurrence risk in premenopausal women but doesn’t impact survival. So I guess it all depends on the goals of treatment.

Dx 12/2021, IDC, Right, 1cm, Stage IB, Grade 1, 1/5 nodes, ER+/PR+, HER2-, FISHISHCISH

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