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Breast Cancer (Expert Forum)
Chemo/Oncotype DX Test
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Chemo/Oncotype DX Test
by Avidhiker, Jul 17, 2006 12:00AM
My Oncotype DX test results came back 25, representing an intermediate risk of recurrence (16%) in ten years. My tumor size was 2.4, Intermediate Grade, ER+/PR+, Node negative and HER2 amplified. Oncologist advised that chemo will reduce the 16% by 3% to 13%. I intend to complete radiation, Herceptin and Tamoxifen (the hormonal treatments will reduce an additional 6%). I have been struggling with the idea of adding the chemo. Will the risks actually be worth the 3% reward? I feel lost in space. Got to move on this fast as my surgery was 7 weeks ago (waiting forever for dr. appointments; doctors are on vacation; waiting for test results, blah..blah..blah...).
Any light that can be shed on this would be most helpful.
Peace to all.
Any light that can be shed on this would be most helpful.
Peace to all.
Doctor's Answer
by CCF-RN,MSN-rf, Jul 17, 2006 12:00AM
Dear avidhiker: This is a very personal issue. Oncologists can present the facts (e.g. 3% risk reduction). We can tell you that most women tolerate chemotherapy quite well without major side effects. However, there are side effects and we cannot predict how any individual will respond. It really boils down to your personal assessment of whether chemotherapy is something you wish to pursue in light of the risk/benefit ratio. Good luck in your decision.
From a 2002 HER2+++, ER+, PR+ 1.6 IDC who was 51 at the time... and has never had Herceptin, only the older standard of CAF (no dose dense), rads, and briefly, tamoxifen and then Arimidex...
IF (make that IF gigantic and bold) you have an onc who has enough of a grasp of honesty and any real comprehension of the likely loss of libido, plus weight gain, metabolism that goes to a crawl, chemobrain, blood counts that generally take years to get back to semi-normal, and joints that are painfully dry without estrogen... and who actually tells you that...
And IF you can spend some time talking to someone who has had recurrence or mets with or without having done chemo...
Then you can make a genuine choice. I was never given that courtesy. I haven't had recurrence or mets and sadly because of that I am expected to be grateful for the failure to be fully informed.
I was paid to work in the woods at the time treatment began and was in excellent shape, and it took YEARS to get back to where I could jump rope without stumbling constantly. I still weigh 18 pounds more than I did when I started treatment.
Did anyone explain yet to you that one side effect of years of hormonal treatment is drier everything, including ears, eyes, joints, and yes, vagina, and that for some of us no amount of lubrication will allow sex to be a pleasure?
A.A.