Oncotype score 27 or higher with reoccurrence

Hello @lpac304 I am sad to hear of your diagnosis, it sounds like you are getting the whole book thrown at you. I am sure you are glad chemo is over. I also took chemo and radiation. This was a few years before oncotype existed so they just did everything.
I can only tell you what I did and what I would do differently. I had a partial above my objections. I was told at that time they just really wouldn’t do a mastectomy for my tumor. Which was anchored to the rib on the upper inside edge of the breast tissue.
I also had a second surgery to try for margins, followed by axillary node surgery. I can’t say that there would have been less suffering with a mastectomy because it might have been harder to detect the relapse, but there certainly would have been less daily discomfort from scar tissue and malformed breast tissue. Because I am an equestrian, I really wouldn’t have missed them if they were gone.😂
I suspect because I was in my 30’s and lumpectomies were shown to be as effective in stopping the cancer during that time, the doctor was resistant to just taking them off. If I had it to do over again, I would demand a bi lateral mastectomy, flat with no reconstruction.
Have you talked about the pros and cons with your doctor? Spouse or family?

Hi @lpac304 .

Very sorry for the hard stuff you’re going through.

I had a mastectomy in October 2024 and am in the reconstruction phase. Although a partial or lumpectomy was briefly discussed, both my doctor and I agreed a mastectomy was the safest way to go.

I wanted to do whatever I could to minimize cancer reoccurrence. Although deciding to have a mastectomy was initially hard, I spent a lot of time online looking at the incredible work that the right plastic surgeon can provide.

I knew myself. If I could have the opportunity to minimize my cancer returning and also have my body look similar to what it has been, those were the drivers for me.

I enjoyed having my breasts before cancer. So for me, it made the most sense to try to have breasts.

Everyone is different. Personal decision for sure. I really never considered this choice at all until I was diagnosed with cancer.

Good luck! Hope what I shared is helpful. Always happy to answer questions about the treatment I am undergoing.

I had lumpectomy in June 2023 and also Oncotype positive. Went through chemo and radiation and now on AI therapy. I have also questioned the same - should I have done the mastectomy which would have avoided the radiation (and have since learned insurance may pay for bilateral mastectomy). But in my research, while mastectomy does decrease reoccurrence in the breast tissue (none there) in the long run, it does not change the outcome ratios. Plus there are side effects to the mastectomy as well, even without reconstruction. So I am now more comfortable with my decision but would definitely re-examine my options if I have a reoccurrence.

@lpac304, I hope you are tolerating your treatments well. At least it is giving you time to consider and reconsider your decision. It's a big one, and always difficult. We all have our own reasons for making the choices that we do. At least today's surgeons are usually open to whatever we decide. My surgeon strongly confirmed that she would support whatever I decided. Last November I had a single mastectomy to flat closure. I wanted the option that would let me get back to living my life as soon as possible. I always wear a prosthesis on that side now, it's manageable, but I'm still looking for a bra that I love that isn't a sports bra. The search continues.
Know that whatever decision you make it will be the right decision for you. If you have any specific questions about the surgery or recovery, please ask.

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