Question: Dear Doc

Hope this gets you well – Attached herewith is my ONCOTYPE DX report. Although all my previous reports are attached but let me recap my case history for your ready reference:

Tumor: Invasive Ductal Carcinoma
Grade: II
Diagnosed on October 25th, 2017
Location: 2.O.Clock – Left Breast
Lumpectomy performed on November 24th, 2017
Lymph Nodes: Clear
Margins: Clear
Size of Tumor: 2.5 CM
ER: Positive
PR: Positive
Her2: Negative
Fish: Negative
Oncotype DX Score: 20

Other important facts:

Age: 46 Years
Menopause: Signs of early stage menopause have been noticed in recent months such as delay in periods
General health conditions: Above average
Side health issues: Experience Migraine / Headache 3-4 times per week
Family History: Nil
Physical Activity: Average 45 minutes rigorous exercise 6 days / week
Personal preference: Would like to avoid chemotherapy
Food intake: Extremely healthy food / diets
Weight: 65 KGs
Height: 5.2 Feet
Bad habits: Consume upto 300 ML of white or red wine atleast 3-4 (11 to 13% alcohol) times per week
Medicines I used before surgery: Calcium, Vitamin D, Primrose & Panadol/Brufen for headache

Questions:

1.     Is it mandatory to undergo chemotherapy treatment followed by radiation and 10 years hormonal therapy
2.     Do I have the option to skip chemotherapy treatment and only take radiation followed by 10 years hormonal therapy
3.     Only Hormonal therapy is sufficient

Please kindly review my report and above details and give me a solid opinion that you deem most appropriate for me

Thanks
XXXX

Dear Doc

Thanks for your reply. I think I did not explained my questions correctly. As of now, the Doctor has advised us that its up to us to decide whether we want to have chemo or not? She is saying that Oncotype DX between 20-30 is a grey area and usually patients are given the choice to decide whether they want chemo or not?

Let me repeat the questions and if possible, kindly review my previous email again as it mentions the present situation

Questions:

1.     Is it mandatory to undergo chemotherapy treatment followed by radiation and 10 years hormonal therapy

2.     Do I have the option to skip chemotherapy treatment and only take radiation followed by 10 years hormonal therapy

3.     Only Hormonal therapy is sufficient

Please advise which one is required in my case - 1, 2 or 3?

Your specific answer is vital because we are based in Pakistan and seek your firm opinion to decide what we should do?

Thanks
Mrs XXXX


Dear Doc

Please see if u can revert within next few hours....would be of great help

Thanks
MRS XXXX

Dear Doc

Please see if u can give me a reply enabling me to decide wether I should go for chemo or not?

Waiting
Regards
MRS XXXX