Hi, I am new to this forum. I wanted to ask people: over 50yrs. I am 54. I have ER+ HER2- breast cancer. Just had lumpectomy and lymph nodes removed which also had cancer present. My oncotype
dx result was 19. Need to decide If I opt for chemo?? Any others been in similar situation please
Hi @Curlyshaz69 welcome to the forum. I’m in a similar-ish position - I’m 53 have ER+ HER2- I had a lumpectomy and positive sentinel node (just one but with extra capsular spread). My oncotype dx score was 16 - so although this is slightly lower than yours its still in the group that if we were <50 they would say there was marginal chemo benefit. I wasn’t given the choice of chemo (communication wasn’t great in the move from surgery to oncology and I was more or less sent straight to radiotherapy - had to push for oncotype dx results discussion) - was basically told the results showed no benefit of chemo. Are you post-menopausal? I think that’s a key thing - I’ve just had a test to see if I’m still peri - but even if I’m still peri-menopausal the chemo option isn’t being presented - that’s more about which anti-oestrogen treatment I have. At the moment I feel ok about the no chemo option - but I think that’s in the context that my tumour is 8/8 on the oestrogen sensitivity so I’m feeling like the anti-oestrogens should do mopping up. I feel more anxiety about not having had further surgical node clearance after the positive sentinel node than I do about not having chemo (I’m having radiotherapy to nodal area). Although I didn’t feel like there was much shared decision making happening when I finally got my oncotype dx discussion, on the plus side it was the first time anyone had taken me through all my pathology results in detail which I did find helpful. Also I came out with a tamoxifen prescription which felt like progress on the mopping up (though I’m sure I’ll be cursing it in a few weeks time when I get the sweats etc). I think the decision about chemo is so individual - size of original tumour, number of nodes etc etc. - good luck with the decision making xx
What’s your grade and your estrogen and progesterone levels? Also, how many nodes had cancer and what was the extent of it?
It is a big decision. I had a mastectomy few weeks ago for lobular cancer. Lymph nodes negative, er +ve and HER -ve. I am currently waiting on my oncotype results but was told that at age 55 if result is under 25 then chemo would not be offered. Please let us know what you decide and sending big hugs x
Hi and thankyou so much for your comments. I decided to just go for Radiotherapy and currently getting my treatment now. Xx
I was 48 when diagnosed. My lymph nodes were negative and my Oncotype DX test was on the cusp, so chemo wasn’t necessary but I opted for it anyway. It was a tough decision. I did really want to go through it. But I figured if bc ever returned, at least I’d feel like I did everything I could the first time around to prevent it.
It really is a personal decision. Think about it carefully and go with your heart and gut. Trust me, you’ll know what’s right for you.
Just as an aside, MLB, my oncotype score came back definitive for chemo since I was under 50. If I was above 50 chemo wouldn’t have been recommended. At any rate, I was actually relieved. I wanted chemo but my husband didn’t want me to go through it, no one did actually, and when the score came back like it did, everyone shut up about it and I could do what I wanted. I would have anyway but it was lovely having no argument about it. I needed chemo for exactly what you stated. Peace of mind. But everyone gets their peace of mind in different ways.
Hi I know you wrote this ages ago but my oncotype came back today and it was 17. I am 42 and my oncologist has said the benefit of chemo is not enough to outweigh the risks. Do you remember what your score was?
Mine was 23 and that meant the benefit of chemo would probably outweigh the risk. I will say if it’s 20 or less than don’t normally recommend it unless there are lymph nodes or LVI involved. With a lower score the tumor cells are less likely to be affected by chemo so if you were to do it, your risks could outweigh your benefits.
Congrats though! I was fine to get chemo and wanted it since I had a grade 3 tumor but it’s not a fun thing so if you don’t have to get it, be happy 
Thanks so much for replying. I just got panicked because I expected it to be less and it made me worry that I should be considering chemo.
Your’s isn’t considered intermediate. Intermediate is between 21 and 25. Mine was intermediate. Your’s is low. No not as low as you would like but nothing would give you a 0% recurrence rate so considering that, a 17 is great! Remember that endocrine therapy is your bug guns anyway.
Thanks for your message. My oncologist said it was a low intermediate result. I just wanted to know a bit more about the result and what it all means. Not having chemotherapy does make sense in my case- I think.
The only caveat you have there is the grade 3 with your tumor because they usually respond well to chemo. But grades are also subjective. The lab is literally counting and evaluating cells so one person could give you a different grade then the other. Also, once you get to a grade 3 that’s it. But there’s a lot of variations among them. A triple negative grade 3 is probably going to be way more aggressive than a hormone positive grade 3 for example. There is no subjectivity with an oncotype score and they know what it means. If you don’t score high enough for chemo to be hugely beneficial and have none of the other risk factors that would make it worth trying, then you don’t. Chemo can do a lot of harm, too. Your rewards must outweigh the risks and for you, it just doesn’t appear to be the case. So yea No chemo!!!
Thanks for your response. Everyone is so helpful. My tumor was a grade 2 and I think KI67 was 5- 7 percent so I am think that came into the oncologists thinking . It’s like a while language I never wanted to learn
Oh yeah that did. For some reason I thought you were a grade 3 but that was obviously someone else. At any rate you can definitely feel at peace considering you have a grade 2.
Can I ask what your oncotype score was?
Hey thanks for replying I am definitely premenopausal but they are still not recommending chemo.