Should I Get Chemo with an Oncotype DX Score of 21?

A question I would want answered is what are the actual percentages regarding if I had chemotherapy vs. not having chemo.

Onc said chemo benefit would be 2%. She said that the toxic risk verse 2% reward would not be worth it. I guess they have another statistic calculated they can plug features in and my risk of distant recurrence is 7% which she said is low. But who actually knows…

That is low. My chemo benefit was 3 percent I think. Didn't make sense to me too do chemo. Maybe get a second opinion?

Your age you might want that 3 or 4 % I decided to do it I’m 39 and had one positive node In treatment- not that bad

Hi @Lindi P Are you on an aggressive chemo treatment? Hows it feeling?

My oncotype was 25. Chemo was offered, but the benefit was the same with Tamoxifen and goserelin injections so I opted for those.

Hi @Umm A I did 4 rounds TC I thought it was tolerable- no one likes chemo but I’m glad I did it

Hi @Lindi P I was just wondering what your treatment looks like, if you don't mind me asking. I had 2 positive nodes with an oncotype of 22. I am doing proton therapy and after I finish that hormone therapy and Verzenio. I just wanted to see if there was much difference.

I have lobular breast cancer that is ER+ PR+ HER- and node positive. My Oncotype was 20, and I opted for 4 rounds of TC chemo before mastectomy. There were no guarantees that chemo would have any effect; however, I just had my mastectomy and node dissection and there were definite chemo induced changes. The tumor was expected to be bigger than 5 cm. It wound up being 1.7 cm.

I’m pre-menopausal, 37, oncotype 16, node negative, HR+/HER2- and opted for 6 rounds of TC. I have no regrets doing chemo. I prefer to know that I did every reasonable prevention measure.

@Dina Z that is such a low oncotype to be offered chemo. Mine was 21 and I’m 39 and i wasn’t even offered. Was your grade a factor i wonder?

It was ultimately my choice. I talked to a colleague at Sloan Kettering and my own onc at the Curie in Paris who is extremely informed and experienced. For pre-menopausal women, it’s not as straightforward. I was grade 2, ki67 20%. I’m glad I did it. I chose TC over ddACT as it’s less toxic and non-inferior in lymph node negative cases.

Women under 40 make up only 5% of BC patients and we’re often not well represented in studies so the resulting models like oncotype may not be as reliable. A 4% risk is not a 4% risk. There’s a margin of error. I chose to reduce that risk as much as possible.

It’s your choice and if you’re unsure don’t hesitate to ask for a second opinion. I did my own research (I’m a scientist) and then got 3 medical opinions.

Are you also taking hormone blockers?

I am premenupasal ,40, Her +,Her2- Grade 2 Ki67 35% Oncotype 19 Did 4 round of TC And now soon gona start Radiation Aftet that AI + Verzenio

I’m on a GNRH agonist and aromatase inhibitor. I opted for this HT because it’s been shown to be superior to tamoxifen.

Yes, Anastrozole. But your diet has to change but eliminating or adjusting for what is fueling the cancer. Mine is red meat, lamb, high protein soy/bean products (like garbanzo beans).

Diane R. How do you find out what is fueling the cancer vis a vis food product?

I'm 47, pre-menopausal, my score was 25 and benefit was 6%. Since it was borderline and there was some benefit, I opted for it. It's up to you, really. You may want a second opinion.

What grade is your cancer? My oncotype was 29 and chemo was suggested and I insisted on getting the Mammaprint as well which came back low risk for recurrence. I had stage 1a, Grade 1, ER/PR positive, HER2- yet my Oncotype came back as a 29 and Mammaprint came back low risk for recurrence. After getting consults from the tumor board at my hospital, and 3 other outside oncologist opinion, all recommended no chemo. One thing you have to take into consideration is the grade level which Oncotype does not take into account) and your other prognostic factors. One thing you could ask your Dr to do is to run the RSCLIN model which he/she should have access to. It takes less than a minute to do and it uses your Oncotype, age and grade of your tumor and gives you the result. That was very helpful to me. I decided no chemo for me and have been on anastrozole now for 4.5 years and also had radiation.

How are you doing on arimidex, im doing 1mg every other day , im 70 with autoimmune disease so we are trying lower dosing ,

Joyce, it is always good to read the information pages you get with your prescription, but I Googled the medication to see what the side effects are, adverse effects, drug interactions with food, etc. I also Googled the type of cancer I have, I have ER+ HER2-, and I looked up what fuels ER+, and it told me what foods I should not or avoid to eat and limit the portions. I do take Anastrozole daily which is the hormone therapy to cut my estrogen buildup. Dense breasts are fueled by an excess amount of estrogen. But most of all, your Oncology Team should help answer your questions. If you have a nutritionist/dietician on your team, they should be able to inform you of what your dietary needs are and share some recipes. I’ve been experimenting with some new chicken recipes, I save to my phone, my latest was peanut chicken. I do have a pressure cooker which cut down on cooking time. You will find out the change in your recipes are minimal. Arm yourself with good information! Good luck and happy eating!!

My oncologist told me that if you are not HER2, chemo is not needed. Also, what cancer do you have? Are you BRAC positive?

Onco was 14. No chemo I thought if 25 and under