Newbie here. Ive recently had a therapeutic mammogram to remove 3x invasive carcinoma tumours HER2 negative. Stage 2 grade 2. They also found cancer in 1 lymph node. I’ve had an oncotype test and the results were 15 and 18 which the breast care nurse said was low risk. The nurse said I needed a blood test and if it showed I was post menopausal (which she suspected I would be) I would need 15 sessions of radiotherapy plus letrozole. However my bloods have shown that I’m pre menopausal so they gave referred me to Oncology to discuss adjuvant chemotherapy.
Has anyone else had this? I’m confused as they told me that my Oncotype score showed low risk.
I had something a bit similar. I had been told that my tumour would be sent for oncotype testing, but once it has been established that my nodes were involved, the oncologist said there was no point doing the oncotype test because the RxPonder Clinical Trial had shown that for premenopausal women with 1-3 positive nodes chemo gave a 5% increase in survival regardless of oncotype score and was therefore a no brainer. Hope this helps. x
Hello.
I’ve posted the BCN info below about Oncotype scores.
The difference in low and intermediate risk is in the scoring for post or pre menopausal women.
In post menopausal women, a score of under 25 is lower risk and usually no chemo if nodes are clear (I was 22).
But in the pre menopausal (or under 50) a score of 0-15 is considered that chemo would not benefit while 16 and above is up for discussion with your team, so I think that’s where the uncertainty around your score has come in.
Being pre or post menopausal is a factor in planning treatment. They can’t go by age as everyone hits it differently, 50 is merely average. I’m 53, not hit it yet, though have started having longer gaps this year. My mother was 58 by the time she’d gone a year without a period (though 63 when had BC - G3, st 2- still going strong at 81, no sign of recurance so far).
Its good they tested you, as the difference is whether you have hormones feeding it or not, and your hormone levels may have been fairly high despite not having periods, so they have checked where you are at.
Sometimes cancers are slower growing in older people.
Hi @mrsc3 ,
I posted this info on another Oncotype strand, but it’s relevant here…
I was 53, had mastectomy and premenopausal, ER+, HER2-, 100mm tumour, 1 node. Chemo was recommended as I was perceived to be at high risk of recurrence. My Predict score showed an 9% benefit from chemo.
The eligibility for the Oncotype test was:
newly diagnosed with early stage invasive breast cancer,
have cancer cells that are ER+,
have cancer cells that are HER2-negative,
are either lymph node negative, 1-3 lymph node positive or have micrometastases in the lymph nodes
have a large tumour size
I paid for my Oncotype test and it showed a 2.8% CT benefit, so very different to Predict’s 9%, and recurrence risk 19. The caveat in the report was that for premenopausal women over 50, it is “not known whether the benefit observed with CT is due to CT alone, ovarian function suppression or a combination of the two.” My treatment plan also included ovarian suppression.
I decided to go ahead due to my age and if I had a recurrence, didn’t want to regret that I hadn’t thrown everything at the cancer.
Standard of care will be chemo if it’s spread to the nodes. Ultimately, it’s your choice though and how you feel about your own risk. Hope that helps.