Oncotype DX Stories

Angela Y.

She had a gut feeling that chemotherapy wasn’t right for her.

One of Angela’s friends, an oncologist, suggested that she use the Oncotype DX test, which the oncologist treating her had also mentioned.

In mid-November 2006, Angela had her annual mammogram. The results showed that there was some calcification in her breast tissue, which can be a sign of cancer. After a second mammogram and a fine-needle biopsy, Angela was diagnosed with breast cancer. She was 42 at the time. 

“Before that initial mammogram, I had no reason to suspect that I had breast cancer,” Angela said. “I had none of the usual risk factors, and there’s no history of breast cancer in my family.” 

Angela saw a surgeon right after she was diagnosed. Because Angela is small-breasted, her surgeon recommended a mastectomy, which offered more potential for reconstruction than a lumpectomy. She had the mastectomy about a week after meeting with the surgeon. 

After a few weeks of recovery, Angela saw her oncologist. He recommended hormonal therapy (tamoxifen) and chemotherapy, but left the chemotherapy decision to her. Angela asked if there were any other treatment options, but found that there weren’t many for pre-menopausal women with pathology results like hers. 

Her oncologist used Adjuvant! Online to gauge how likely Angela’s cancer was to return if she proceeded with both tamoxifen and chemotherapy. The combined therapy could decrease her likelihood of recurrence by 5%, and increase survival by 1%. Based on these results Angela didn’t think this information was definitive enough to make a decision. 

Beginning in January 2007, focusing on the long-term effects of chemo, Angela began to do her own research. After pouring over various studies, she discovered that some of the potential chemo side effects, such as memory loss and heart damage, may occur. She also read that the immune system can be weakened significantly. With this info in mind, she worried that the side effects of chemo would diminish her ability to care for her large family, and as a mother of four and a caregiver to her parents, she had many depending on her. 

At the time of her diagnosis, Angela had a gut feeling that chemotherapy wasn’t right for her so she turned to God and friends for additional advice. One of Angela’s friends, an oncologist, suggested that she use the Oncotype DX test, which the oncologist treating her had also mentioned. Her Recurrence Score result was a 22, which put her in the intermediate-risk range. Although Angela was relieved that her result wasn’t higher, she had hoped for a lower score that would more clearly show that she was unlikely to benefit from chemotherapy. Ultimately, Angela decided against chemotherapy.

“I want to inspire people to do the things they always wanted to do, but never thought they would. You never know what tomorrow holds, so do it today.”

In February 2007, Angela began tamoxifen therapy. She also enrolled in a clinical trial investigating the use of exemestane in pre-menopausal women. She was randomized to the control group of women taking tamoxifen. 

“Some of my friends have recently been diagnosed with breast cancer, and they’re pre-menopausal, like me,” she said. Angela also has three daughters, so she is eager to support research that could benefit future generations. 

Now 44, Angela is doing well. Always fit and energetic, she has taken part in two triathlons, and has remained an active member of her local Church. Today, she stresses the importance that faith played throughout her life – especially since her diagnosis. “Cancer has helped me to not take things for granted,” she said. “I want to inspire people to do the things they always wanted to do, but never thought they would. You never know what tomorrow holds, so do it today.”

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How Angela's Oncotype DX Recurrence Score impacted her treatment decision.

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Name: Angela Y.
Age: 42
Year Diagnosed: 2006
Recurrence Score: 22

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