Treatment Post Radical Masectomy with LVI and 2 Lymph nodes involved. Will OncoType DX test be useful to asses chemotherapy effectiveness.

[pjain]

My mother 67 years old was diagnosed with BC in right breast, Grade 2, ER+,PR+,HER2-, Ki 67 20%, tumor size 2.8 cm

Had radical mastectomy and right axillary I and II lymph nodes removed. Now have received post surgery, pathology report with impression as below -

Right breast (mastectomy + right axillary level I & II lymph nodes): Invasive ductal

carcinoma, grade 2, 2.8 cm.

Margins are uninvolved by carcinoma.

Lymphovascular invasion is identified.

The second nodule lateral to main tumor mass shows 2 lymph nodes with metastatic

carcinoma. Overlying deep resection margin is uninvoled by carcinoma. Size of largest

metastatic deposit is 12 mm. Extranodal extension is identified.

Right axillary lymph nodes (0/16) are uninvolved by carcinoma.

In light of above observations, with 2 neighboring lymph nodes involvement, does Lympho Vascular invasion pose significant risk in terms of metastasis / recurrence.

Appreciate any suggestions for further course of treatment based on above pathology results. My mother is already terrified with the thought of chemo/radiation therapy.

Thanks

pjain

[roxboxfox RadiationOncologist]

Hormone Therapy Benefit 2%

Chemo Benefit 1%

as per NHS Predict v2.0

Radiation is definitely indicated.

[pjain in reply to roxboxfox]

Thanks doctor, this is encouraging. Have also sent sample for OncoType Dx test and awaiting results.

[pjain in reply to pjain]

Hello Doctor, We have received OncoType DX results and recurrence score is 1 (One). Based on this score, consulting Onco is ok to skip chemo and planning to start with radiation therapy next week. Assuming radiation therapy is a must irrespective of OncoType DX RS score.