CTS5 and Oncotype DX

Posted by sandyjr @sandyjr, Jun 27, 2020

I had never heard of CTS5 until I read it on this site. I am not quite sure how it works. From what I read, it is a calculator that figures the chances of getting a recurrence of breast cancer after 5 years of taking an aromatase inhibitor. I am not sure if this calculator is figured at the time of cancer being found or after 5 years of aromatose inhibitor usage. I am thinking it is used to see if it would be beneficial to extend the usage of aromatose inhibitors beyond 5 years. My first incidence of breast cancer was 13 years ago...DCIS and I took tamoxifen for 5 years. The second time I got it in the other breast 2 years ago, I had the Oncotype DX test done and it suggested I did not need chemo as my chance of getting BC again was less than the score of 25 and this test is done from the tissue/information of the cancer itself. Then last fall I found out I have the CHEK2 genetic mutation which, I think, changes everything. I am wondering how the CTS5 can determine if additional usage of the medicine would be helpful when not all of that information goes into the calculator. There are a lot of variables. Also, is the Oncotype DX score relevant? The genetic mutation is not considered in that info as far as I know. How could it be if the mutation has not been found yet?

As far as the aromatose inhibitors go, I will take what my doctor recommends and have no problem with taking it for more than 5 years if it will help prevent getting BC again. Also, I am scheduled for a bilateral mastectomy/diep flap reconstruction in a couple of weeks. I am not too excited about this, but want to control my situation as much as possible.

I had some discomfort while taking tamoxifen, but could deal with it knowing that it might help lessen my chances of getting BC again and figuring that the discomfort showed that the medicine was working. I have had some minor issues with the anastrozole, but will deal with it. I guess the worst thing that I am experiencing is an occasional shooting pain in my left wrist. I found that putting ice on it has helped. My oncologist always inquires if I am having trouble with my hands, so I guess that complaint is common.

I sure would appreciate input and opinions. Thanks.

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I cannot answer most of your questions; I will be checking back frequently to see if others do as I am interested in finding these things out myself. I am four years out from having breast cancer. I had neoadjuvant chemotherapy, then a bilateral mastectomy (my choice, I didn’t want to only have the affected breast removed), then radiation therapy. I have been on anastrozole for four years now ( I do have some side effects but they are not debilitating). I just had a checkup and my medical oncologist says we will do this test in six months to see if I should continue with the anastrozole for another five years. She said they test the actual tissue from my tumor which evidently was saved from my surgery.

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@chamisa

I cannot answer most of your questions; I will be checking back frequently to see if others do as I am interested in finding these things out myself. I am four years out from having breast cancer. I had neoadjuvant chemotherapy, then a bilateral mastectomy (my choice, I didn’t want to only have the affected breast removed), then radiation therapy. I have been on anastrozole for four years now ( I do have some side effects but they are not debilitating). I just had a checkup and my medical oncologist says we will do this test in six months to see if I should continue with the anastrozole for another five years. She said they test the actual tissue from my tumor which evidently was saved from my surgery.

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@chamisa
I was a pathology secretary years ago. Upon surgery, a sample tissue is always saved to paraffin blocks. From that, a minute sample is sliced off and placed on slides. Should further inspection be needed in the future, more slides can be made up. It's up to the facility how long they keep the blocks, but in the hospital I worked at they were kept for years.

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Thank you for the information. Is it the hospital that keeps the slides? This test has never been mentioned to me. I will ask my oncologist about it the next time I see him. I think it is a moot point for me as I am getting the bilateral mastectomy with reconstruction next month and I have the CHEK2 mutation, but knowledge is a good thing. I have never come across a mention of the test with all the reading I have done on BC and related topics.

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@sandyjr

Thank you for the information. Is it the hospital that keeps the slides? This test has never been mentioned to me. I will ask my oncologist about it the next time I see him. I think it is a moot point for me as I am getting the bilateral mastectomy with reconstruction next month and I have the CHEK2 mutation, but knowledge is a good thing. I have never come across a mention of the test with all the reading I have done on BC and related topics.

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@sandyjr
The Pathology Department of the hospital should house/store the slides.

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