Hi @A MyBCTeam Member - I had IDC Invasive Ductile Carcinoma and still have residual DCIS after 2 lumpectomies, which is why I’ve opted for a BMX once chemo is done. My first oncologist offered 4x TC every three weeks after if I wanted to do chemo. .It was my 2nd opinion at Sloan-Kettering who offered CMF 8x every three weeks. Neither oncologist could say I must to chemo since my score was 21. It was optional and up to me to decide.

The intermediate risk score range is 11-25 and 25 + is high based on the most updated scale. You should read the TailorX clinical trial update in The New England Journal of Medicine that came out this past spring to help you decide. It breaks down into more detail of Onco score and age and benefit of chemo in the charts. These charts were not in the general news articles. It is well worth the read. Link is here:

https://www.nejm.org/doi/full/10.1056/NEJMoa (Phone number can only be seen by the question and answer creators)

https://www.nejm.org/doi/full/10.1056/NEJMoa (Phone number can only be seen by the question and answer creators)
https://www.cancer.gov/news-events/press-releas...

CMF is twice as long in terms of number of treatments, but less toxic and just as effective. The side effects are much milder than TC. No hair loss, usually no Neulasta needed to maintain WBC count on 3 week cycle. That can cause bone pain. You can read more about the experience on this link.

https://community.breastcancer.org/forum/69/top...

Please do your research/reading and weigh all the options to decide what is best for you. With a score of 27, I would consider it.

Mentioned Users

A MyBCTea...

CMF is a good option. Chemo was optional for me - tumor 1.2 cm I think and my onco score is 21. With a 27, you are on the higher end of moderate and can choose chemo or not. Please read my story/board and ask your oncologist about CMF. It is a more tolerable chemo and I wish doctors would offer it for moderate scores. Sloan-Kettering still uses it a lot, which is where I am.

Thanks for the info - actually they say lobular does not respond as well to chemo so another vote against it

I was wndering why you got the oncoscore for a 5mm tumor, its very small. You got opinions for no chemo from Mayo and Johns Hopkins, two institutions that are leaders in breast cancer research. Quite honestly I’d be leary of even staying with the oncologist recommending chemo at this point. Why is he pushing it? Chemo is given after weighing risks and benefits ibecause these drugs are toxic and can cause long lasting side effects. Did you know that oncology practices buy chemo drugs from pharmaceutical companies and administor them at substantial profits ? In other words, some unethical doctors might push chemo to make money. Is this oncologist pushing chemo in a highly regarded research institution like Mayo and Johns Hopkins or is he in a private practice?
I was told told that i might need rads after BMX, igot 2 opinions. One oncologist recommended rads, the other didnt. I decided the risks outweighed the benfits and didnt get them. The decisions are hard, but in your case you have highly reputable institutions telling you not to do chemo, id follow their recommendations.

You are thorough and have a lot of good opinions from great institutions! Four seems to be enough and I hope you can come to a decision to give yourself peace of mind. My tumor was 1.2 cm and th gain from chemo is just another 3%. I am not familiar with lobular unfortunately.