Adjuvant Online information

[gadabout]

My oncologist ran Adjuvant Online and printed this for me which shows  22% prognostic risk of 10 year relapse.  With no additional therapy: 69.6 alive and without cancer in 10 years, 21.3 relapse and 9.1 die of other causes.  With chemotherapy, it lists "Benefit = 6.1 without relapse".  Just to clarify, does that mean that chemotherapy adds only 6.1 to the 69.6, increasing the amount alive and without cancer in 10 years to 75.7 and dropping the relapse to 15.2 from 21.3?

I'm 59, Comorbidity - average for age, ER Status - Negative, Tumor Grade 3, Tumor Size .9 cm, 0 positive nodes
Oncologist has recommended 4 cycles of Cytoxan and Taxotere, but I don't think this is listed in Adjuvant Chemotherapy.

Thank you

[gadabout]

Yes, Ray, I am ER/PR-, HER2- which means no response to Herceptin. I remember hearing about a newer version of Adjuvant Online to be released soon, so maybe that will have added HER2 status as well.  I don't think CT is listed on the current version, either.

dblwhammy,  my tumor is a recurrence (same location) from 2000 which then was 8mm, ER/PR+, HER2-, 0/14 nodes.  Treatment was lumpectomy with clear margins, radiation and 5 years of Tamoxifen.  But,evidently a small part of the original cancer remained despite the treatment and has mutated and come back a little more aggressively and is now triple negative, which I understand can and does happen.  So  with negative receptors, the Oncotype DX won't work for me either.  If that test would have been available in 2000 with my first tumor, it might have showed a much stronger chance of recurrence and I could have opted for mastectomy then......might not be in this situation now!   As it was in 2000, I was told that there was very low risk of recurrence - maybe about 7%.  Not sure what tools were used then to come up with the 7%, but here I am in the 7%.

Dr. Paul, I didn't mention in my original post that I am TN which is probably why my oncologist is recommending CT instead of AC.  

Thanks everyone for your responses.  Blessings to all!

[dblwhammy]

At age 59 I also had a 12 mm tumor, grade 2 negative sentinel node, Estrogen positive, Her2/neu negative. Originally I was to begin Arimidex with no need for chemo or radiation as I had double mastectomy. My oncologist suggested an additional test called Oncotype DX to determine a recurrence score based on past models of tumors with the same genetic markers. My recurrence score was relatively high with 20% chance of recurrence. He strongly recommended 4 rounds of cytoxan and taxotere which I completed in mid March. Treatments weren't too bad and the extra 'insurance' has helped me face my future a little more brightly.

[Ray515]

Do you know your HER2/Neu status?  Was your biopsy positive for the overexpression of the HER2 protein?  If so, keep in mind that Adjuvant Online does NOT take the HER2 status into consideration.

I had similar results from Adjuvant Online but was wary because my cancer was HER2 positive and that was not considered by Adjuvant Online.  I really wonder how much the Adjuvant Online results would change if HER2 was included.

I just finished 4 rounds of Cytoxan and Taxotere and am following up with Herceptin once a week for a year.  The four rounds were not fun but if I can do it so can you.  You will feel bad for about four days and will need a full week to get your energy back.  But the following two weeks weren't bad until I was hit with another round.

Good luck whatever you decide.

[PaulMD]

Hi there.

Yes, your interpretation of the figures are correct. Chemotherapy will add about that much percentage on your risk of being disease free, or alive, at 10 years from diagnosis.  The regimen of Cytoxan and Taxotere are only indicated for patients who have a contraindication to receiving Adriamycin, such as those with heart problems (congestive heart failure).

If you have no cardiac co-morbidities, you can opt to receive an adriamycin containing regimen, but there may be no significant difference in terms of additional survival compared to taxotere-cytoxan, adriamycin is cheaper though.

Regards.