• My oncologist gives me the choice of chemo or radiation and hormone therapy or all ?

    Asked by hallothere on Saturday, February 9, 2013

    My oncologist gives me the choice of chemo or radiation and hormone therapy or all ?

    I was diagnosed with Multifocal in-situ and invasive pleomorphiclobular carcinoma with focal ductolobular differentiation and focal extension deep specimen margin close to my breast-muscle. I had a total right mastectomy . the surgeon stated he got everything. My sentinel node and axial were clean , the tumor was classified as T2, Estrogen R = positive , progesterone R= positive HER2 2+My Onco test was low . Don't know the exact # at this point. So what is my best choice?

    7 Answers from the Community

    7 answers
    • nancyjac's Avatar

      Statistically if your onco score is less than 18, then chemo has not been found to be helpful in most cases. So if that is the case, you might consider the radiation and hormone therapy. If you are also HER2 positive, you might want to ask your oncologist about Herceptin infusions.

      over 3 years ago
    • Nomadicme's Avatar
      Nomadicme (Best Answer!)

      Typically her2+ are quite aggressive. However, a low OncoDx score indicates a low probability of recurrence. Look at the graph that comes with your score, it will give you a probability of recurrence in 10 years (with active hormonal therapy). So say the probability is 4% in 10 years (with hormonal therapy). Chemotherapy lowers risk by half, so it would be 2%. Also remember that chemotherapy is more than just a bad time, it can make other comorbidities worse, age you faster, it even leads to leukemia on sme cases (low probability, but it happens). So it's all a risk/benefit analysis at this point.
      I don't understand why you need radiation of you had a mastectomy?

      over 3 years ago
    • SueRae1's Avatar

      Speak with your oncologist and ask her/him about the benefits and side effects of each of the treatments. You may also want to get a 2nd opinion to help clarify the pros and cons. I Think every one should get 2nd opinions, because i truly believe another pair of eyes and someone with slightly different experiences in treating people with my cancers can only help me and my team devise the best possible treatment plan.
      I never had the option of choosing my therapy, but the 2nd opinion confirmed that the plan was one they would use, I also go some suggestions about genetic testing and sequencing, which my oncologist loved and is now using with other patients.

      over 3 years ago
    • hallothere's Avatar

      I had two tumors in the same breast , the second was deep , close to the breast muscle , but the margin was clean , they want at least radiation the area of that muscle. Thanks for your answers, it helps me some in making a decision. the second tumors was only detected by the MRI. Financially , I really can't be out of work for the long treatment of the chemo. So ,I really have to put this in perspective , but I also don't' want it to come back in my left breast or anywhere else!

      over 3 years ago
    • gwendolyn's Avatar

      I don't understand how your onc expects you to make this decision. Did he make a recommendation? Did he give you relevant stats for people who have cancer with similar attributes? I would not be comfortable being handed this choice. Personally, I would ask for more guidance, if not from this doctor, then another one.

      over 3 years ago
    • karen1956's Avatar

      I would recommend a 2nd opinion.....
      I can't help with the oncotype test as it was not used for me as I had many positive nodes....

      over 3 years ago
    • Nancebeth's Avatar

      I had mixed tumor ER+, PR+, HER2-, left breast only. Had bilateral mastectomy with immediate reconstruction. My Oncotype score was 24. Chemo recommended by both oncologists I spoke with and also breast surgeon. I had 6 sessions of CMF. I worked the whole time I was chemo. I did not need radiation. However, I couldn't handle the side effects of the Tamoxifen so I stopped it after 2 months.

      over 3 years ago

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