melissad's Cancer Blog
March 8, 2010
After much consideration, I’ve decided to resume chemo and take 3 cycles of AC, probably starting next week. It seems worth the small risk of a long-term disability to have a better chance of being cured of cancer.
I really appreciate the support that’s been pouring in over the past weeks and months. It helps a lot!
March 5, 2010
I got my score today: 20. That puts me on the low-end of the “intermediate” section. This is relatively good news, though not the “low” number I was of course hoping for. An explanation of results scores can be found here:
http://www.oncotypedx.com/ManagedCareOrgs/OncotypeOverview.aspx
I’m thinking now that I will resume chemo, with 3 more AC cycles. I know that is what my oncologist recommends. I guess I’m gradually accepting that going through the discomfort of more chemo and the risk of some permanent disability is better than a premature death in the next 10 years.
I found the summary below from conference proceedings in 2005 (published on http://www.stopbreastcancer.org/index.php?option=com_content&task=view&id=343). I’m not sure if there are more recent results that apply to me (pre-menopausal, ER+, node-negative, stage 2). My read is that doing hormone therapy plus chemotherapy will drop my chances of recurrence in the next 10 years from 7.2% to 4.5%.
I am bummed but hanging in there. Thanks for the on-going support. A couple of drop-in visits this week really helped lift my spirits. You know who you are!
Here is the section:
Oncotype DX
New research was presented by the NSABP Operations and Research Center that the 21-gene recurrence score (RS) assay, previously shown to quantify the risk of distant recurrence in estrogen receptor-positive (ER+), node negative patients receiving tamoxifen treatment, can also be used to predict local/regional recurrence. (For background information on this assay, see NBCC Fact Sheet on Prediction of Recurrence Using the Oncotype DX Test
Three groups of node-negative, ER+ patients were included in the study, (1) tamoxifen treated patients, (2) placebo treated patients, and (3) chemotherapy and tamoxifen treated patients. The distribution of patients who had a lumpectomy versus mastectomy was about even between the three groups (approximately 40% lumpectomy patients versus approximately 60% mastectomy patients). All lumpectomy patients received radiation therapy after their surgery. Although significant findings were reported in all three groups, the most significant association between RS score and local/regional recurrence was found for patients treated with tamoxifen: the 10-year local recurrence rates for low, intermediate, and high recurrence scores (RS) were 4.3%, 7.2%, and 15.8% respectively, p < 0.0001. This means that 96% of women with low risk scores survived for at least 10 years without a local/regional recurrence of breast cancer. On the other hand, 84% of women with a high risk score recurred. For placebo-treated patients, the 10-year local/regional recurrence rates associated with low, intermediate and high risk RS were significantly higher than those in the tamoxifen group (10.8%, 20.0% and 18.4%, respectively). In patients treated with chemotherapy and tamoxifen, all local/regional recurrence rates were found to be significantly lower (1.6%, 2.7%, and 7.8%) for low, intermediate, and high risk RS.
These findings infer that the 21-Gene Recurrence Score can be helpful in determining local treatment decisions and follow-up requirements for patients with node-negative, ER+ breast cancer.
Dear Melissa,
I, too, came back on the low end of inconclusive on my OncoDX test and I really considered throwing a tantrum when I realized I’d waited 3 weeks just to have to make the decision re: chemo myself anyway! Like you, though, I was grateful for the info the test did provide and it, along with my doc’s advice, helped me make the decision that felt right to me. It sounds like you feel the same about your decision, which is as it should be, even if it’s difficult. You’ll do great and you’ll be all the stronger for it!
Peace,
Kathy
Posted on Dear Melissa,
Boy, you lost me with all of your numbers though it sounds that you are making the best decision for long term. Though, in all honesty I am not familiar with breast cancer treatments and only what I have read, you of course want the one that will give you long term survival. I do know for a fact that CHEMO SUCKS BIG TIME! But, you have your whole life ahead of you. I do believe with each passing year they will come out with newer treatments. I, am proof positive of that for when I was dx. in 1994 with CML I was told I had 3-5 years at best. The treatment I am on now was only a dream back then. Thankfully, I was able to raise my children for they were 8, 10 & 15, and I was a single parent with no help or support from their father. There is not a day that goes by that I am not giving THANKS for these years. I pray that one day you will be doing the same.
Keep your chin up and on your worst days turn to one that has beaten the odds. Though, I do not have breat cancer feel free to contact me anytime, though I still have my days, but I’d like to think I have much more better ones that bad ones. I pray and wish for you a long life.Be Well, Patty
Posted on chemo was so, so difficult, but it’s the best insurance policy we can give ourself. I did it too, and boy it was so scary…but it ENDS thank God! I see you have a little one too! You’re in my prayers!
Posted on 
Thanks for your support - 
Hopefully I’m posting this in the right place. Thank you so much for writing back so quickly. Thanks for letting me know you feel that way too, sometimes people think that since my hair is coming back, that I’ll snap back to my old self, but some days are just so hard, like you said…Thank you agai, I like this site, and will see you on here, and keep the prayers flowing!xo
I know that is a tough choice. Sometimes I wish the treatment was just black and white. That would be so much easier. We are here for you and will be fighting this with you.