Can pre menopausal women have this test to check suitability of chemo for
Preventative cancer treatment? I’ve had surgery already and oncologist really wants me to have chemo. I have stage 2, ER+ variant, tumour was 37mm and 2 of my lymph nodes were positive. All others however were clear. Surgery was a success, predict tool showed chemo having a 2% benefit. I’ve requested a second opinion as I really didn’t get on with my oncologist.
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My understanding is that Oncotype testing is only done for premenopausal women who are node negative…
it’s worth asking though? xx
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If I had 2 nodes positive I’d be wanting chemo regardless of any other parameters. Have you used the new or the old predict tool? I’m surprised it’s only come back as 2%, given that I got knocked back for chemo at 1.9%, however, was only a grade 1 without any lymph node involvement. Did you put the details in predict, or did they say you were over 2% as I’d of thought you’d get a higher benefit score than that under the circustances.
I used the new predict tool v3.
@clp1 - I think that oncotype testing is only done if you have smaller tumours but I could be wrong .
However you need to chat to your HC team , can you ask to see a different oncologist if you feel you aren’t gelling with your current one ?
I know no one wants to put themselves through chemo but It’s worth pointing out that chemo isn’t something that’s recommended lightly , so if your team are recommending chemotherapy then it will be because they believe it’s in your best interest x
Arty1
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Hello.
Here is a link with a bit more info about who might be able to have their tumour oncotype tested.
My tumour was 32mm so it’s not dependent on size. It’s usually on hormone positive, HER2-, post menopausal women.
The link I’ve posted states that node positive women may be tested but only if post menopausal. Anyway have a read and I think the Breast Care Nurses would be able to chat through any questions you have if you give them a call xx
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I was told from the outset that due to my age (46 at the time, premenopausal) that chemo would have been recommended if either the grade ended up being higher after surgery and/or it was present in any lymph nodes. I know ultimately it would have been my decision had either of those things applied, but as far as my team were concerned it would have been a non-negotiable. Oncotype testing was never even mentioned. x
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I was called back after surgery as two of my lymph nodes were infected. That was the reason they recommended chemo. I was willing to take whatever treatment was offered to extend my life and also had radiotherapy. I was premenopausal. xx
I should think long and hard before having chemo.it depends on the drugs they want to give you.ive had 4 cycles of docetaxel and its horrid stuff.
Hi, the V3 has not yet been approved for use on NHS to my understanding.
Try V2 to see what you get from that.
Good luck,
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But V3 is based on more data and much more up to date. I am a statistician by occupation and I trust the analysis behind the tool. NICE guidelines take forever to update, but it makes sense to use V3 to base decisions on as opposed to V2 which is out of date now.
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Yes I agree. Such an important decision to make.
They want me to do 6 sessions The regime they are suggesting something called EC-T chemotherapy, it is a combination of 3 chemotherapy drugs,
E – epirubicin
C – cyclophosphamide
T – [docetaxel].
I wouldn’t hesitate to agree if the stats came out in excess of 5% but the new data suggests much lower.
I’ll get a second opinion from a different oncologist that can answer all my questions and see where I get to.
X
Yes i had 4 cycles of docetaxel and found it hard going as i had a lot of side effects.
I had my first cycle of ec nearly two weeks ago still feeling fatigued they have to monitor my heart as this drug can be hard on it so had an ecg and having a heart echo done.
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When considering predict, given your young age, the 15 year survival is the figure to look at. However, even then, it has its limitations, as it doesn’t go beyond 15 years - which most people around 50 would hope to double those years really. Also, its a measure of mortality, not recurance and chemo prevents spread. The progress, recent times, that has been made, has resulted in more women living with metastatic cancers for a long time, but anyone would hope to avoid it progressing to that if possible. Unfortunately, there are no measures or predictions of recurance as there are too many individual variables.
I’m premenopausal, despite being 53, if I had any cells in 1 lymph node I’d be insisting on chemo to reduce likelihood of recurance. By how much, nobody will ever know. It occurs to me that predict can only be based on data collected from what has already happened, so it would be the prior 15 years data, however, with treatment changes, those figures will change for the future 15 years, which are the years that matter most to us. Its a blunt tool, its the only thing we have that measures, but it’s also arrived at from past data, so limited in its ability to predict the next 10 or 15 years, despite its name ( perhaps it should be changed to ‘chances of death for people in the last 15 years’ - it’s less catchy though).
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I was premenopausal and had the oncotype test done. I didn’t have any nodes involved and my score was 18 so they gave me the choice to have chemo if I wanted. As I wanted to do everything I could to hopefully prevent a recurrence I did chemo. Seems like my body is defying me though as despite having chemo, doing radiotherapy and 5.5 months of hormone therapy I still had a recurrence. 
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I just posted on a different thread about the RxPonder trial, which shows 5% benefit for node positive premenopausal women Oncotype test low risk but premenopausal - #2 by flower5
I was pre menopausal with a similar size grade 2 tumour and only 1 lymph node involved amd I was told that Chemo would be of benefit. I went with the professionals advice because I wanted to give myself the best chance. I wasnt exactly relishing chemo but its super important to note that not everyone reacts the same. Some people will tolerate chemo really well and others less so. Unfortunately its the negative experiences that tend to stand out.
Predict V3 isnt recommended for use at the moment and while there may be sound logic behind how it has been compiled the reluctance to launch it as the go to tool does suggest to me that there are still enough concerns. Otherwise it would have been adopted. I personally can’t reconcile how my 15 year prognosis has leapt from 78% to apparently over 90%. I mean, it’s amazing if true but it does seem a too good to be true leap so maybe there is some nuance missing in the new model?
Theres more info to put in on the v3, but I do wonder, if some of details asked for, are just because the data is easy to collect rather than significant. It strikes me as odd that risk comes out different on the basis of if the tumour was spotted by mammogram, or found yourself. Seemingly better via mammogram. Seems odd that if you are a person who checks themself and spots it early, its any better for a mammogram to spot the same size tumour thats the same grade and stage. It doesn’t make sense. How is it relevant? My tumour was less obvious on mammogram, slow growing allegedly, so likely there on previous mammogram, just lucky it was high up where there is less tissue so easier to feel. But if I’d waited till the following month when next mammo was due, and it got spotted by it, the figures would be given as better, despite a month going by, plus another month waiting for the callback, whereas I had my biopsy results and a plan about 2 months or so earlier than if a machine found it the month after. Glad I saw my GP the next day after finding it.
I also have a letter stating that the reason I was not offered chemo was because predict gave it a 1.9 % improvement which wasn’t deemed big enough. So that suggest that yes, oncologists do use predict to decide on treatment plans - though I certainly hope it’s really more individual and nuanced than that.
Hi I was diagnosed aged 40, 11 years ago and had the oncotype test. I had 17mm tumour er+ her2 negative but no lymph node involvement. I was told that the tumour was 99% positive to estrogen and my score came back as 16 oncologist said chemo wouldn’t benefit so took tamoxifen for the following ten years