Should I get chemo for hormone-positive breast cancer with low risk score?

This is such a challenging decision that many people in this community face, and it's completely understandable to feel uncertain when weighing the potential benefits against the side effects. The decision often comes down to personal factors like quality of life priorities, support systems, and individual comfort with risk. Many community members find it helpful to discuss questions about long-term effects, fertility considerations if relevant, and alternative treatment timelines with their care team to feel more confident in their choice.

I was 49, stage 2b and the oncologist said I was borderline as to whether chemo would benefit or not. I wanted to do everything I could to prevent it from ever coming back. Chemo wasn't always fun, but I feel better knowing that I am doing everything that I possibly can to give it the least possible chance of coming back.

I was on the fence as well with an Oncotype score of 29 Stage 1 ER/PR+ HER2- and KI67 of 1%. I was diagnosed at 60. Since my score was an outlier from all of my prognostic factors, I also did the Mammaprint. The Mammaprint came back low risk so I did not do chemo. Then the RSCLIN model came out and my doctor ran that quick model and that was also favorable odds with no chemo. So you may want to consider these options as well if you are unsure about what you want to do.

Do you know your KI67? Chemo only targets fast growing cells so if it’s low the benefit may not be there and I would talk to your dr about that. The higher the ki67 the more beneficial chemo will be. And I would also get a second opinion.

I am 54 and was Stage 1 grade 1 with a 6mm tumor and oncotype score of 27. I’m currently waiting for my last chemotherapy treatment. My oncologist told me it was my choice but if my tumor was 1mm less and my oncotype score was 1 number less I wouldn’t have had the chemotherapy discussion with him at all. He made my decision easier when he said it would reduce my chances of a recurrence from 15% to 5%. I chose to go through with chemotherapy because I still have a lot of living left to do and my 2 year old grandson needs his nana in his life along with his sibling on the way. It was a really hard decision but I have invasive lobular carcinoma and I made the decision knowing chemotherapy would kill any remaining cells. I still have 3 weeks of radiation ahead of me and at least 5 years of aromatase inhibitors. I have been lucky and not had many side effects. Just leg pain, weakness and tiredness. It seems if you’ve never had morning sickness and don’t get car sick you tolerate it better. Who knew? Good luck to you.