oncotype

[jsmith0507]

I am 50 years old, just got my oncotype score and it is in the gray area too - 20.  I had an 8-mm tumor with lumpectomy and Mammosite radiation.  My radiation went very well with no inflammation, zero.  It was great.  

My problem is the intermediate score.  I am estrogen-receptor positive, progesterone-receptor positive, postmenopausal, HER-2/neu negative, and genetic testing was BRCA 1 and 2 negative.  Also node-negative.  

I am offered Arimidex for five years and/or chemo of taxotere and cytoxan for three months - four doses.  I am confused.  I am told that I have 87% chance of no recurrence right now, with Arimidex it goes up to 90% and if I choose chemo that goes up to 93%.  My med oncologist is leaning towards me not having the chemo but I do not know what is the right choice.  

Anyone with suggestions would be most welcome.

Thanks.

[Katie2u]

With a score of 20, if your tumor was 1cm or greater I would choose both.  If you read the OncoDX website, the intermediate range middle score is 14 so you are higher than the 14, however with a tumor as small as yours they may not prescribe chemo.  I would definitely take the Arimidex.. I think taking nothing is too risky.  I am ready to embark on the Taxotere/Cytotoxan treatment.  There are medications to control most of the side effects.  My doctor told me that if you put your hands and feet on something cold like frozen vegetable bags or ice during treatment it will lessen or eliminate the tingling/numbness.  I'm going to try this.  Good luck!

[Fernando Roque, MD]

Hi.  I think your choice comes down to this:  Is the additional 3% improvement in recurrence-free survival worth the potential long term side effects brought about by the chemotherapy?  Some of the adverse effects of Taxotere may be long lasting, such as the intermittent muscle cramps and the numbness/pain/ tingling at the tips of the fingers and toes.  Before making your decision, my suggestion is for you to look up the list of potential side effects of Taxotere, Cytoxan and Arimidex and see if these are things you can put up with for the long term.  You may also wish to speak with other people who have actually used this regimen to see what how they reacted to these drugs.