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Aromatase Inhibitors: Did you decide to go on them or not?
Breast Cancer | Last Active: May 12, 2023 | Replies (1190)Comment receiving replies
I'm confused by those tests risk evaluation. I'm not familiar with the tests as I only had the OncotypeDX. Is their (not low) 5% a risk of loco-regional recurrence? If so for what time span? If they are analogous to the OncotypeDX risk analysis, what do they consider a low recurrence risk?
A 1% or 2% would be lower than the average risk of recurrence for estrogen positive cancers IF one threw every possible treatment at it, including radiation, chemo and adjuvant anti-hormone therapy. So do those tests have no low risk at all or only the narrow 3-4%? That seems to be threading the needle so carefully. Or are they of more value in estimating the higher risk levels?
Conceptually, it's hard to get a risk much lower than 5% as cancers have recurred in people who did everything to prevent them. To the tune of 3%-4% if my oncologist is right. At any rate, just curious, but do you know what risk estimate is considered low for those firms' testing protocol?
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I will dig out my records. For one of those, I think it was close at 4.5% for the low risk cutoff. but I don't want to rely on memory. I did these tests at the 5 year point of AI treatment. Breast Cancer Index tells you benefit of continuing on anti-estrogen meds, since many now do 7-10 years. It gives risk of distant recurrence for years 5-10.
Prosigna Assay, also known as PAM50, also measures risk of distant recurrence in years 0-10 for those treated or going to be treated with anti-hormone meds.
You mentioned "throwing everything at" a cancer, including chemo. That concept went out the window with genomic testing. According to the Oncotype, there is no change in risk by not doing chemo for those with scores indicating no benefit. In fact, chemo may do more harm than good.
I will dig out my scores. I was shocked that with my Oncotype of 8, these other tests had me at high risk. Oncotype basically told me that chemo was not of benefit. But with grade 3 and LVI I had my doubts about low risk. Nevertheless I am 7 years out, knock on wood!