ONCO Type DX results in.... Chemo or not?

[caseykootenai]

Stage 1, lumpectomy, clear margins, ER positive, HER-2 negative, size of tumor 2.2 cm length by 0.2 cm diameter. Lymph node showed no cancer under regular microscope but when additional specific dye was added showed a "speck" of cancer.. his words... not mine.  ONCO Type DX test came back with score of 13.. out of 100.. very low.. again.. his words. Showed chemo would not really be helpful, but I asked for one more weekend to make my final decision, and looking for ANY kind of advice, words of wisdom.. Thanks ladies!    Wow, I am so much better at this second post giving all the info.. sad but funny!  :)

[ncmichigan]

Hi, Casey,
I'm so sorry to hear about your cancer diagnosis. I just wanted to add that
I agree with Sue Young 100%. If it were me, I'd definitely get a second opinion and definitely consider the chemo. You have a lot in your favor, but that "speck" is scary to me, too. There's no way to tell if that "speck" hasn't spread other "specks". As blue butterfly said, chemo would greatly reduce the risk of further spread even though it can be tough. Of course it's your decision and you have to do what feels right to you, but you asked for our advice and we're giving you our best thoughts.
I wish you all the best whichever choice you make, successful treatment and a healthy future.
Take care,
nc

[SueYoung55]

I'd get a second opinion. Your oncotype score is fabulous!

I really dislike that "speck" of micrometastasis though.

I always err on the side of caution.

I don't blame you for wanting to bypass chemo though, it's not a picnic!

Whatever you decide will be the best decision for you.

[bluebutterfly2222]

No problem.

Glad to hear it's a (favorable) Grade 1, non-aggressive cancer.

I still think a 2nd opinion would be valuable, esp. if you are even slightly unsure as you seem to be since you posted this question.

And even though you asked for the weekend to decide, no one can hold you to that.  Your decision could be that you need MORE time, to obtain another opinion. ;->

Please update us regarding what you decide and how things are going.
bb

[caseykootenai]

sorry about that.. It is Grade 1.

[bluebutterfly2222]

In the future, please keep all related posts in the same thread. (I just now discovered that I have answered you before, and have repeated much of the same information.)

We prefer that people keep their  posts in one thread, so that: 1) all of their information will be available in one place, which helps us to provide better answers; 2) we will be able to see the answers that have already been given, so we do not duplicate our efforts; and 3) readers interested in a particular thread will know when additional developments have been  discussed.

Thanks!
bb

[bluebutterfly2222]

Hi,

Do you know the grade  of your tumor?

You have  several favorable factors and your Oncotype Dx was low, so many might skip chemo (assuming the tumor grade is also  low).

However, the standard of care has been to consider chemo when a tumor is over 1cm, and certainly when there is lymph node inolvement. Your path report indicated "only a speck" in a node, but chemo is  a systemic tx that can reach micrometastases that might have gotten lose anywhere in the body, whereas radiation (which I assume is planned?) only affects cells in the targeted area.

For peace of mind, I'd suggest a 2nd opinion onco consult. And if you decide not to take chemo, be sure to take full advantage of hormonal tx (tamoxifen or and AI, depending on your status re menopause).

Best wishes,
bluebutterfly

[caseykootenai]

oops forgot something.. of course.. I'm considered nodal negative 0 even with the "speck"