How did you decide on breast cancer treatment based on Oncotype?

Thank you so much. There was no such test when I was diagnosed. Even though I read about it, to learn, some things are just more complicated than a simple answer.

Amazingly I was able to avoid chemo despite my grade 3 tumor. That is the main benefit of the Oncotype. And those with high scores can be sure they are doing chemo because it is necessary. The intermediate scores provide ambiguous guidance.

I had a radiation seed implanted the day before a lumpectomy. The surgeon explained that it helped identify the exact location of the biopsy, using equipment located in the operating room. It was removed, along with a titanium marker also inserted aforehand, during the surgery. I think, but don't know, that the purpose was to be expert vigilant in capturing any rogue cells that might have been displaced during the wide-needle, vacuum-assisted biopsy procedure.

It sounds as if your oncologist called it right, maybe based on some combination of data and experience dealing these cancers. I would also suspect it might have come back sooner, or even more aggressive, without the chemo giving your body a chance to recover to fight again if necessary. That's a success story in a way.

I am not sure if this thread is still active but I am going to try anyway. @kszilvia @kszilvia, I was diagnosed in June 2022, with surgery in August 2022, with Invasive lobular carcinoma, grade 3, pleomorphic with necrosis. I am waiting for my Oncotype, but like you, I found studies that show Oncotype and chemo are effective indicators with lobular, see the below link.

add the w w w to this to et the link. I am new so cannot post links.
.mdanderson.org/cancerwise/What-is-invasive-lobular-carcinoma-8-insights-on-lobular-breast-cancer.h00-159539745.html

I had the radioactive seed as well and they said it was for location. I opted for a lumpectomy and am not sure what I will do when I get the Oncotype score.

I see some people had recurrence with chemo, some without, but this kind seems likely to come back.
@schindler, I am so sorry to hear your cancer is metastatic. I don't want to overstep, but was curious if you are willing to share, how long were you cancer free.

I have so many questions and feel so uncertain about so many things. This is so overwhelming.

I did find that Cleveland Clinic is researching as is Sloan Kettering and MD Anderson. I am shocked at how most stand of care for this cancer appears to be lumped with ductal when they are so different and I am so thankful for the research that Mayo, Cleveland, MD, and Sloan are doing. Terrifying that this become resistant to the treatments and equally terrifying how long you have to take them.

Any advice is appreciated.

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- 8 insights on lobular breast cancer https://www.mdanderson.org/cancerwise/What-is-invasive-lobular-carcinoma-8-insights-on-lobular-breast-cancer.h00-159539745.html

When do you expect to get the results of your Oncotype test and to review treatments options?

So here I am trying to make a decision regarding chemo treatment after an oncology meeting next week. The facts are single mastectomy for invasive carcinoma no specific type, grade 1 stage 1 ER PR positive, Her 2 negative, clean nodes and margins following surgery. I started on letrozole 2 months prior due to delays in scheduling and continue with minimal side effects. The Oncotype score of 28 is intermediate and surprised the oncologist. Does letrozole prior to surgery affect the Oncotype score? At 75, I am reluctant to have chemo when I consider all the positive results of my cancer. What to do now?

I don't know if Letrozol does have an effects but if it did then it would rather I prove the test results. That means the results would be worse without the Letrozol.
You did not have any affected nodes? If you have you can ask your Do Tor about CDK 4/6 inhibitors together with letrozole. That is not as heavy as a chemo. But don't know whether you can get that without affected Lymph nodes or high risk. Personally my chemo fehlt like a Wall in the Park compared to the treatment with zoladex and exemestan that I have to do now. It is 'only' 6 months and there are good treatments for side effects. So don't be too scared about it. I was really really scared and was amazed of how 'easy' it was to get through it. I even worked! Since the exemestan I am unabke to work. Have heavy depression and fatigue :/
Talk to your Do Tor about it and See what he recommends. And if you're still u sure get another professional opinion. If both say chemo I think I would Do it.
Greetings

@nlb122, how did the meeting with oncology go? I hope you got some clarity about letrozole prior to surgery and the Oncotype score. I would love to hear what you learned and what treatment decisions you made with your team.

We did meet with the oncologist who reviewed fully every item on my pathology report. We discussed the all clear with a bilateral mastectomy and low possibility of recurrence and additional treatment. She did not think letrozole prior to surgery would affect the results. With a mid-range score of 28, we decided that chemo was not an option at my age. She ordered a mammaprint test to get more clarification but we are still waiting for the results. Because I will be more than 120 days from diagnosis, chemo benefits may be reduced anyway. That’s a consideration for anyone who is delayed for treatment. The process is now in place with mastectomy completed and an AI for 5 years with regular monitoring. We hope that is a good ending to my health story.