Oncotype DX Score, confused what to do

[nancyg]

Hi.  I just got my Oncotype score.  The test is confusing me even more.  My score was 20, but before the test my prognosis was much better.  I had a small tumor (.8 cm), and was considered low grade.  I had a lumpectomy followed by mammosite (that's another problem/question)  The oncotype score states I have a recurrence rate of 13%.  That seems high.  I talked to my surgeon and he was shocked.  He thought that particular score must include local recurrence too.  I'm even more confused and don't know what to do.  It is totally my decision, my oncologist thinks that I'd be fine on just the Tamoxofin, but he said noone would fault him if he put me on chemo with an onco score of 20.  I honestly wish I didn't have the test, it just raised more questions.  If I was low, I would feel confident, if I scored high I would have felt the test was worth it, but now ????

[jayme doe]

Your age should be important in decision for chemo as well, and if premenopausal ER+,it sounds like you're in a grey area. I assume since you didn't mention it, no significant family history to indicate genetic testing (and surgeon would probably have offered something like prophylactic mastectomies for your consideration.)Of course the test you took was designed to try to eliminate some grey areas, eliminate needless chemo, (though that's still not universally accepted) but may have alerted you that you might benefit-again probably still not universally accepted. As a Radiation Onc, I see pts making these chemo judgement calls all the time, usually without benefit of Oncotype.Hopefully Med Onc can help you sort it out. Mammosite's a different story.

[nancyg]

Hi.

Thanks for your comment.  I saw my Oncologogist yesterday, and he told me it is my decision.  He just ordered Genetic testing, although that's just to see if I should have my overies removed.

I am 51 years old, on the verge of menopause.  All other factors were good, small tumor, low grade, highly estrogen receptive.

My oncologist thinks I should do fine on Tamoxofen for two yearsfollowed by an aromatose (spg?)  inhibitor.  

I also used to drink a lot of red wine, and have cut back to one glass per week.  

My oncologist is leaning towards no chemo, and that's the avenue I think I'm going to take.  THe oncologist at oncotype says his tests are very accurate, but I think tumor size and grade contribute also.

[nancyg]

You're a radiation oncologist.  I had the mammosite and its been 8 weeks.  I have severe inflammation that at first was treated as an infection.  My breasts are small, and my medical oncologist thinks I might have not been a good candidate.

Just wondering how long the burning and the inflammation will go away.

[jayme doe]

Breast size, distance from skin to mammosite catheter should have been considerations in suitability. I'd hate to speculate from here.Hopefully it will resolve soon if it even is related.

[jnstoi]

Have been on Femara for a year after lumpectomy, HR Rec +, no nodes, radiation, no chemo.  My oncotype score was 1.  My question is can I stop Femara.  I am having strong reaction including fatigue, pain, swelling, numbness in fingers - wondering what the long term effects of removing estrogen from body are.  I feel 90 and I am only 59.