To chemo or not to chemo

I have er+/her2-  bc. Clear margin after surgery but sentinal node-pos. 2nd surgery, 15 further nodes removed and all neg....yay!! My dilemma now is whether to have chemo as well as radio/hc....I have no issue with the radio/hc but chemo quite frankly scares the pants off me!! Oncotype dx score 15 and am under 50yo, pre-meno with 2 young trenagers. Dx score suggests chemo will be of little to no benefit but oncologist pushing me quite hard down that route. Anyone had similar dilemma and what decision did you come to? 

  • Hi,

    I also had an oncotype score of 15, er+ her2 neg, I had no lymph node involvement clear margins. I did not have chemo as the benefit, for me, did not out weigh the chemo fear etc. that was 2 years ago and I've just had my second clear mammogram. It is a personal decision but I spent some time researching the research done on oncotype scoring and risk v benefits. I was 49 when I was diagnosed and have 2 children. It is difficult but the scoring system put the benefit of chemo for me at 4%.

    maybe ask your oncologist why they think it's advisable, mine did not suggest I should have chemo as post surgery my tumour was downgraded from a grade 3 to grade 2.

    good luck in your decision making and do what's best for you. I did have radiotherapy and I am now on tamoxifen for 5 years xx

  • 123nelly Thank you for sharing and I do hope results of your 2nd mammo are in your favour!! My oncologist is very pro-chemo which stems from their own personal experience. By their own admission, other oncologists may suggest chemo not of significant benefit! I've been researching ODX results and there's not quite so much available for those that are er+/her2-/N1+/pre-meno. References of reliability of scoring for those that are node+ generally lean towards post-meno. It's such a minefield of information to try to process and all I really want and need is to find all the info in layman's terms!! Haven't found that yet though!! 

  • Hello K5001

    I just wanted to pop on and suggest that you might want to give our team of nurses a call. They can't advise you on what to do but I'm sure they will be happy to talk things through with you and explain in layman's terms some of the information that you would like clarified to help make your decision. 

    They're available Monday to Friday 9 am to 5 pm on 0808 800 4040. 

    Best wishes 
    Jenn
    Cancer Chat moderator 

  • Hi 

    I was similar to you had 55mm tumor and one positive sentinal node removed , will be having radiotherapy to others starting next week.

    I was going to have Onco test but due to mess up at the hospital that didnt happen , anyway I decided to have chemo regardless.I had 16 sessions and it has been mostly not too bad.I am glad that I chose to have the chemo but definately found it a hard decision especially as mine is lobular which apparently doesn't respond as well as other typesto chemptherapy.I think my fear of recurrence would be greater if I hadn't taken it.

    Mines also er+/her2- so have started Tamoxifen as well x

    Good luck

  • Hello,

    Yes my onco test came back as 9 so oncologist said straight away that I didn't need chemo. I was happy with that but have since heard that some people DO still have chemo if they're onco test comes back a low number (well under 26 as I understand it) 

    I am still happy not to have had it after two clear mammograms. I feel really well and healthy and don't look back with any regrets. DO find it odd though that oncologists vary so much over this.  After all it's quite a big decision! Is it different if you are pre-menopausal or post menopausal though?? Perhaps that's the important factor?? ( I was post)
     

    Hope you get the treatment you want.  Good luck!!! 
     

    Kebbs. 

  • Hi [@K5001]‍ 

    In a very similar situation to you , just got my post surgery results Friday and chemo has been put on the table as I went from stage 1 to stage 2 as the tumour grew a bit! Nodes were clear. Surgeon has asked for further tests which I assume is the Oncotype and said about 3 weeks.

    Also told I need radiotherapy which is fine, but also Tamoxifen ( er+) but I don't want that as I have had a dvt in the past. They said something about putting me into menopause so I can try a different drug , which I'm also not keen on. And obviously chemo isn't something to have unless it's really, really necessary so I am hoping that the test will give some more clarity.

    At this stage I'm leaning towards just having radiotherapy and hoping for the best! I also have several chronic illnesses and don't have a particularly high threshold to medicine side effects...other people manage fine and get some reassurance from taking them but whatever you decide it has to be right for you.

    Keep asking questions.

    Best wishes :happy: