• Oncotype score

    Asked by Mariana on Monday, July 16, 2018

    Oncotype score

    My oncotype was 27 on a tumor stage 2 A, grade 1 A. No lymphatic nodes were compromised, neither chest wall, or lymphovascular. My oncologist wants me to have radiation therapy and more chemotherapy after bilateral mastectomy. ( I already had neoadjuvant chemotherapy). I am thinking of refusing both treatments and stay on Hormonal Therapy. Has anyone refused therapy?

    11 Answers from the Community

    11 answers
    • ChildOfGod4570's Avatar
      ChildOfGod4570

      I know my oncologist didn't give me a choice when I was in active treatment, so I was unable to refuse chemo; however, I do know of a lady who, after her second infusion and a horrible ordeal with side effects, refused further chemo back in 1990 and put all of her trust in God to heal her naturally. She did have radiation but no more chemo, and she is about to be 28 years NED. I think everybody is different, and the decision to take or refuse treatments should be discussed between doctor and patient. What you need to do is weigh the benefits and drawbacks to having further treatments. Did your doc say you would most certainly benefit from the chemo and radiation? Did he or she say that your chances of recurrence are much lower with treatment. What I personally would do is anything I could to keep the cancer from coming back. I don't know if it's true for all cases, but someone once told me that treatments for recurrence is worse on the patient than those when the patient first started active treatment. I hope I have been of some help for you. Please talk to your doctor and see what would make you better off at the end of the day. HUGS and God bless.

      about 1 month ago
    • monamo's Avatar
      monamo

      Hi Mariana, I have an oncotype 16 on a stage 2a and I believe grade 1a. I only had to take tamoxifen. I’m looking at my oncotype report and it shows a recurrence graph for different treatment options. I remember my oncologist also sharing with me a gold standard protocol that is usually followed when selecting treatment. That said, if you’re not comfortable with what you’re hearing for treatment or rationale - get a second opinion. I see G. Nagaraj at LLUMC and find her reasonable and not overly prescriptive. Good luck to you. Such a hard time in this whole process.

      about 1 month ago
    • WoodArtiste's Avatar
      WoodArtiste

      I had a lumpectomy over 4 years ago and was advised to do chemo and radiation. I was completely put off by the doctor's attitude when I asked him about the results of a second opinion on the test I'd asked for to be sure it truly was cancer. His answer was, "Well, you have it." Then he asked if I had history of breast cancer in the family. I said no and he said, "Well, you're the start of it." I opted to have the breast removed (not using this particular doctor) and to get as much of the tissue as they could to get a clear reading. The test showed a good likelihood of having got it all. We all know that means little. Those little buggers are usually sneaking around somewhere. I went on Anastrozole for one month and went off it due to extreme joint pain. Here I am 4 years 3 months later with Stage IV metastacized bc. In beginning stage of looking into radiation and seeing chemo doctor for first time today to see where to go with this journey next. Each case/person is different and our personalities have a lot to do with how we go with it. I believe God will lead me a day at a time. This time around I have been lead to a radiologist who is fantastic and caring. Today I find out if the chemo doctor is the next step on my journey with God at my side.

      about 1 month ago
    • grammyk's Avatar
      grammyk

      Given your age and oncotype score, I would definitely listen to the dr. You could always get a second opinion. God bless!

      about 1 month ago
    • Cynderbrik's Avatar
      Cynderbrik

      Every patient has the right to refuse treatment--it cannot be done without your consent. That does not mean it is a good or "the right" decision. There will be patients who do nothing and it never comes back and patients who do everything and it does return. Scientifically, everything about recommended treatment is statistics. But doctors have incentives to encourage treatment. If your doc is using scare tactics or telling you that you "must" do X instead of giving options, recommendations, and seeking YOUR decision, find another doc.

      Regardless, get a second opinion. Radiation is so often used, with or without chemo, so consider that. Is Mayo or similar an option for you (cost, insurance, travel, etc.)?

      Make the best decision you can, but recognize that there is a crap shoot element to who has the cancer return and who doesn't no matter which treatment is chosen. Whatever decision you make, good luck and then live your life.

      about 1 month ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      Newest results of the TailoRx study classify an ODX of 27 as over the line into "high risk" for recurrence w/o chemo & endocrine therapy. Stage IIA (I presume by size, rather than lymph node status) is 2-5cm--which explains the neoadjuvant chemo to shrink it. The new guidelines, and remaining tumor size (amd perhaps younger age), are likely what is motivating your onc's advice to do BMX and more chemo. Ask for ONE second opinion, at the most state-of-the-art brest cancer center you can afford. I don't get what you mean by "grade1a." Grade is 1, 2, or 3--and it's extremely unlikely a Grade 1 tumor would have an Oncotype score of even >15. Did your onc mean that the tumor HAD been Stage IIA before neoadjuvand chemo but what remains is still Stage IA? (Stage is size+ lymph node status and is expressed in Roman numerals, Grade is a component score of characteristics that indicate degree of aggressiveness, and is expressed in Arabic numerals).

      Before you decide, you owe it to yourself to educate yourself about your cancer--it's your body and your life and you need to understand what you have and what you're facing. Too many patients either accept their doctors as all-knowing and unquestionable; too many others have preconceptions and are convinced that the medical community is out to make money off them. READ as much as you can--Dr. Susan Love's Breast Book and Breastcancer.org are essential resources.

      about 1 month ago
    • ChicagoSandy's Avatar
      ChicagoSandy

      Sorry about the typos--tough to type with a big cast on my L arm

      about 1 month ago
    • barryboomer's Avatar
      barryboomer

      Refuse and run don't walk to another Onc..

      about 1 month ago
    • monamo's Avatar
      monamo

      Mariana - 27 may be on the line but discuss this article with your oncologist. https://www.medscape.com/viewarticle/897537?src=soc_fb_180713_mscpedt_news_onc_tailorx&faf=1

      about 1 month ago
    • WoodArtiste's Avatar
      WoodArtiste

      To update on my journey; the radiologist decided he could not get the entire cancer area due to a suspicious lump on my arm. Sent me to a chemo dr. to check that lump but he says my areas of cancer are not likely to be treatable by radiation. I will begin chemo next week.

      about 1 month ago
    • gpgirl70's Avatar
      gpgirl70

      I am thinking you had AC chemo to shrink the tumor and your doctor is wanting you to complete the chemo series with Taxol. I had surgery (mastectomy), 4 AC chemo treatments and then 12 Taxol treatments followed by radiation. Your situation is different because you had part of your chemo treatment before surgery. The Taxol chemo is much easier than AC chemo so that's the good news although it does have it's own unique side effects like neuropathy.

      Remember that you choose your treatment plan and if your doctor is not respectful of your wishes, then get another oncologist. A second opinion is never a bad thing.

      I opted for doing the standard course of treatment because of my staging and tumor pathology. I wanted to be aggressive because my cancer was aggressive. Before cancer, I had a very healthy lifestyle but I've since focused on eating organic and plant-based.

      about 1 month ago

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