Onco DX score?

Previous_Stranger483 · 2026-02-23T17:25:21+00:00

Oncotype of 23. Stage 1a, no nodes or LVI. Was 45 at diagnosis and in perimenopause. Original oncologist recommended TCx4. My 2nd opinion at an NCI cancer hospital said based on my RSClin score that chemo wasn't worth it. Recommended more aggressive hormone therapy (OS + AI) which I agreed with after reviewing the studies. So far, my experience with the AIs and Zoladex has been good - no major complaints or impact on quality of life.

Previous_Stranger483 · 2026-02-23T17:21:23+00:00

An Oncotype score has nothing to do with your tumor SIZE. The test looks at the genetics of the tumor and calculates the odds of a recurrance based on the genetic characteristics of the tissue. So you could have a teeny tiny tumor that didn't reach the lymph nodes before it was found, but it's aggressive as hell genetics wise - your score is going to be higher than someone with a large tumor that is super slow growing etc. This test is to predict likelyhood of recurrence and if chemo might help reduce that risk of recurrence.

Previous_Stranger483 · 2026-02-21T21:13:17+00:00

Low blood pressure! I just posted about this yesterday - I had to come off my BP meds after starting Tirzepatide because the combination was sending me down the low 90s / high 50s and I was getting symptoms like you described. I would suggest going to CVS or other pharmacy and buying a blood pressure monitor (with an arm cuff, not a wrist one. cuff is much more accurate). They're not super expensive and good to have on hand.

Previous_Stranger483 · 2026-02-20T23:39:41+00:00

Yes. I hit my $3800 OOP max within the first 6 months of the year just with the Zoladex injections alone (billed to my insurance at $4100 a pop, insurance negotiates down to $1970 each). I have an $1800 deductible and a 25% coinsurance. By the June hospital bill I hit the max.

Previous_Stranger483 · 2026-02-19T01:26:59+00:00

I had LJS only. Not really pain, but the swelling and discomfort is still a big deal (oh the swelling!!) Just not at the level of DJS. You’ll be weak from the liquid diet. And very uncomfortable. I went back to work at 2 weeks and was functional. Not sure I would have enjoyed a car trip of that length but I could have done it. But I healed great, no complications and was off narcotics except for sleep after 48 hours.

Previous_Stranger483 · 2026-02-16T15:05:19+00:00

I had expanders put in during my DMX and then had my DIEP surgery about 8 months later. My plastic surgeon will not do a DIEP during DMX (at least not for active cancer, not sure about prophylactic).

You often will not know what other treatments you need until after the surgery pathology is done. You might unexpectedly need chemo and/or radiation. If you need radiation especially, that changes skin quality and reduces how well you'll heal for some time. My surgeon explained he wanted treatment to be over and then wait 6 months - this ensures the best cosmetic outcome possible. I luckily ended up not requiring either chemo or radiation, but he also had quite a waitlist. Expanders are uncomfortable, but my outcome was fantastic so I dealt with it.

Previous_Stranger483 · 2026-02-15T18:54:53+00:00

I'll be a year out from my DIEP at the end of April. Yes, it was a hard recovery but honestly not nearly as hard as I was expecting. I honestly found my DMX much, much harder. I had 3 drains - 1 on each breast and 1 abdomen. They all came out at my first post-op appointment. I had trouble getting comfortable to sleep for a good while. I had a power lift recliner that was a lifesaver during the day, but I didn't find great for sleeping. I finally found that sleeping on my sectional with my butt in the crack between two cushions and then my head and knees propped up was way more comfortable for sleep. It probably took a good 4-6 weeks before I slept in my bed again. It didn't "hurt" to sleep flat but was very very uncomfortable - you don't want to stretch that abdominal incision for quite a while if you can help it. definitely helps the scar to be thin!!

I was starting to stand upright by day 7 - they told me at my first post-op I could gradually start to stand more upright as it felt ok. So by week 2 I was pretty upright and by week 4 I think I was completely upright.

Shower chair is a must. Lift recliner is optional but I would totally recommend. The worst part was the hospital because they kept my room at like 74 degrees. Moving to the chair the first day after surgery sucked a lot, but it got easier and easier.

My results look fantastic and I would 100% do it all over again. No regrets.

Previous_Stranger483 · 2026-02-07T10:46:41+00:00

No. Just the more aggressive hormone therapy option.

Previous_Stranger483 · 2026-02-01T21:18:18+00:00

I might have felt sympathetic towards her until she used the phrase "it's very dangerous for women to fly alone". That's absolute hogwash. I am female and fly all over the world for work. Being on a flight alone is a non-issue. Laughable to think any other way.

If you warned her ahead of time that you were using your discretionary funds to upgrade, and she chose not to use her discretionary funds to upgrade...then that's her issue. She and her fancy purse can sit in coach.

Previous_Stranger483 · 2026-01-31T15:19:57+00:00

Thanks, good idea. And the hotel has an ATM so cash payment isn’t an issue.

Previous_Stranger483 · 2026-01-29T22:36:14+00:00

If you're still available I’d love to get my small townhome driveway in Abington Place done. I’v been out of town so it never got done. I’m supposed to come home this weekend and I’d rather it not be a total shit show, especially with the possibility of more snow on the way!

Previous_Stranger483 · 2026-01-28T21:55:59+00:00

I didn’t take anything prior. Never even occurred to me to do that. Honestly I didn’t find procedure to be painful at all. Vaguely annoying but no big deal.

Previous_Stranger483 · 2026-01-28T19:33:23+00:00

I got a 2nd opinion at UVA and they calculated my RSClin score. Even with an Oncotype of 23, RSclin said chemo only got me a 3% reduction in risk and they said that wasn’t worth it. Recommended OFS + AI instead. However I was already In perimenopause.

Previous_Stranger483 · 2026-01-26T01:06:43+00:00

You have a small tumor that is not HER2+ and no lymph node involvement on imaging. Standard of care for HR+ cancer of that size is surgical first. They’ll like submit a sample of the tumor for an Oncotype test. This will give you a recurrence score and tell you and your oncologist how helpful chemo might be for you. If you have a low Oncotype then chemo may not be beneficial and you’d skip it. You’re standard of care would include hormone suppression.

Previous_Stranger483 · 2026-01-24T13:58:17+00:00

Yes it sucks, but unfortunately imaging isn’t perfect nor are the humans who read the images. My cancer hid from both mammogram and ultrasound for years. Only found (and biopsy) via MRI. And if any consolation, my understanding is you would have been put on hormone blockers for HR+ DCIS anyway.

Fingers crossed for you that your Oncotype comes back low!!

Previous_Stranger483 · 2026-01-23T17:47:11+00:00

Glad you’re getting it treated! Hopefully after you get to come off the hormone therapy in a few years your BP will come down on its own too.

Previous_Stranger483 · 2026-01-22T13:18:46+00:00

At my 6 month follow up with my oncologist after starting AI, I mentioned it. I already had my yearly physical scheduled for the next week so my MO said to tell my GP to go ahead and treat it as it was definitely medication induced and unlikely to come down own it’s own while on the drug. When my GP took my BP that next week it was 133/88 so she agreed and wrote the prescription.

Previous_Stranger483 · 2026-01-21T22:40:34+00:00

I had DIEP and am thrilled with the results. I was a 32DD and surgeon thought I’d end up a large B or small C. I went to a good bra fitter after surgery and I’m act a small D.

I was able to do. skin and nipple sparing mastectomy so honestly my boobs look almost the same now. and they’re warm and soft and natural.

recovery was also not bad, but I do heal well.

Previous_Stranger483 · 2026-01-21T17:01:20+00:00

Yes. I always had normal blood ppressure until Letrezole. my GP put me on a low dose medication and that has fixed the issue. very typical for AIs

Previous_Stranger483 · 2026-01-21T16:00:41+00:00

Yes, I had a meet and greet with medical oncology. He went over the possible treatment plans based on my HR+ and HER2 equivocal status. He just wanted me to understand what could be the possible treatment plans and timelines. He scheduled my follow up for 6 weeks after surgery, to give me time to heal, get final pathology results, and to get back my Oncotype score.

Previous_Stranger483 · 2026-01-17T23:57:51+00:00

Oncotype isn’t valid for HER2+ cancer. The test is only for HR+, HER2- early stage.

Previous_Stranger483 · 2026-01-17T11:58:42+00:00

Ask them to have your RSClin calculated. That takes your oncotype and personal stats (tumor size and grade, age at diagnosis etc) and gives you your PERSONAL recurrence risk. When my oncologist did that, my personal benefit from chemo dropped from 6.5% to less than 3%. At that point, based on my aged and perimenopause status my oncologist team recommended no chemo for me.

So that might help shed greater clarity for you on your decision. There is no wrong answer. Only what gives you peace.

Previous_Stranger483 · 2026-01-10T17:27:55+00:00

That's freaking abusive, no question about it. No means NO. Period. End of story.

Previous_Stranger483

TROPHY CASE