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@vegada So I am post double mastectomy with immediate reconstruction 6/26/26 and have a very low risk for recurrence (5% with taking endocrine therapies and around maybe 8% without taking anything). I was stage 1 grade 1 invasive ductal carcinoma and with oncotype DX of just 13. I am having a very hard time agreeing to taking the medications due to all the side effects and my limited benefit... plus I already have osteopenia in my left hip I just found out.... I have the option of taking Tamoxifen as well but it does not have that risk but some other risks.... So many decisions but the medical oncologist is not pushing me to take due to my numbers... it does seem they downplay the risk of bone thinning but it seems a lot of women are affected with their bone health. I will know more on my decision when I get back genetic testing and also the Signatera lab as well. Wishing you and all reading the very best!
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@janiern2 I hear you on all the difficult decisions we have to make for cancer treatment. My cancer was very similar to yours except my Oncotype was a 29, much higher than my doctors and I expected. I decided to also do the Mammaprint since the Oncotype was so unexpected and the Mammaprint came back with a low risk of recurrence. Until I took the Mammaprint my doctor said I should have chemo which I pushed back on because the Oncotype result was the outlier compared to all of my other clinical factors. After much debate and a really stressful time, and consulting the tumor board and two other external doctors for a second opinion(total of 10 doctors) they all agreed no chemo. It was a reversal of a recommendation that would not have occurred if I didn’t push for the Mammaprint. So I understand the real stress these difficult discussions place on all patients. How did you doctor determine your risk of recurrence? Did they use the RSCLIN model to determine your risk or was it determined by the score on the Oncotype? In terms of bone health, I totally agree with you that some oncologists don’t really discuss in detail the impacts on bone health and I really feel that is a big mistake. Bone health is so so critical and it is something I didn't pay much attention to all of my life. I was just blessed with good bones until my breast cancer diagnosis and taking the Anastrozole. My risk of recurrence according to my Oncotype with taking Anastrozole was much higher and two years post my cancer treatment they came out with the RSCLIN model which takes into consideration your age and other clinical factors that the Oncotype does not. The RSCLIN model showed that 95% of people with my age, tumor size and grade, are not expected to have a recurrence, and 5% of the people would have a recurrence and 3% of the people with a recurrence would benefit from chemo. I am just sharing all of this because it is just another example of difficult potentially life altering decisions we all have to make. You are very wise to think about your bone health and get comfortable with the direction you want to go.