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Does Chemotherapy Help In Treating Oncotype Breast Cancer?

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Posted on Fri, 29 Apr 2016
Question: If a breast cancer patient has bilateral tumors, is ER/PR+, HER2-, Grade 1, 2cm XXXXXXX and has an oncotypeDX score of 13, should she have chemotherapy?
doctor
Answered by Dr. Indranil Ghosh (2 hours later)
Brief Answer:
not much role of chemo

Detailed Answer:
Hi
Thanks for your query.

These appear to be low risk tumors as per the size, grade, receptor status and oncotype scores. So, chemotherapy hardly provides any benefit. Only risk factor is the presence of two positive lymph nodes. But recent data shows that oncotype score predicts even in 1-3 node positive patients.

If you give chemo, in this patient the benefit in risk reduction may be around 2%, which is too low. Hence, I would not recommend chemotherapy.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Indranil Ghosh (1 hour later)
Thank you, Dr. XXXXXXX Your answer is consistent with NCCN and research results on Genomic Health's website. Unfortunately, the patient received four cycles of TC. Reduced from dose-dense AC-T once the recurrence score was reported. I'm not an MD, but a friend of the patient and CEO of PatientWithPower. Your recommendation is the same I got from other sources. I appreciate your reply.
doctor
Answered by Dr. Indranil Ghosh (1 hour later)
Brief Answer:
difference in practice exists

Detailed Answer:
Some doctors and centers have not yet adopted oncotype dx fully in node positive patients. They are waiting for the results of the prospective study RxPONDER to come out. So difference in opinion is common.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Indranil Ghosh (12 minutes later)
Understandable that doubts about Genomic Health's results are questioned, as the sample size was very small in the node positive study. Per your advice, I'll track the RxPONDER trial for future guidance. Thank you for your additional feedback.
doctor
Answered by Dr. Indranil Ghosh (2 hours later)
Brief Answer:
sure

Detailed Answer:
If you have no other queries, then please close this query and give feedback
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

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Does Chemotherapy Help In Treating Oncotype Breast Cancer?

Brief Answer: not much role of chemo Detailed Answer: Hi Thanks for your query. These appear to be low risk tumors as per the size, grade, receptor status and oncotype scores. So, chemotherapy hardly provides any benefit. Only risk factor is the presence of two positive lymph nodes. But recent data shows that oncotype score predicts even in 1-3 node positive patients. If you give chemo, in this patient the benefit in risk reduction may be around 2%, which is too low. Hence, I would not recommend chemotherapy. Hope this helps. Regards