The number thirteen is lucky in Germany. Being of German-Italian ancestry, I’d hoped this past Friday the thirteenth would bring some good news from my HMO’s oncologist. In short, I was hoping he’d recommend radiation treatment only following my breast cancer surgery. No such luck. Chemotherapy and radiation are both on the list.

I learned that oncologists use a software program called “Adjuvant! Online” to help them with their recommendations. The program, combined with a patient’s history, pathology slides, blood work, and mammography film, are the main tools employed. But let’s face it. When a pathologist grades a tumor as highly aggressive (grade 3) chemotherapy is going to be in the mix.

My tumor received a grade of 3, and my case seemed fairly straightforward. So I was beginning to question the need for a second opinion. Then this line in the paperwork given me by the oncologist caught my eye: The need for chemotherapy among women with hormone receptor-positive, node-negative breast cancer is controversial . . . That is my profile.

I went to the www.uptodate.com internet site (from which the oncologist had printed the papers he’d handed me) and learned that whether or not to recommend chemo for women with my profile is a major area of controversy. The benefits, according to studies conducted by the National Cancer Institute (NCI), are small.

What the NCI studies do recommend is hormone therapy. My oncologist recommends it, too. There are two standard types. One blocks estrogen in the body from telling cells to grow. The other inhibits the body’s estrogen production. The problem? One recommended drug can lead to blood clots and uterine cancer. Potential side effects from the other include arthritis and osteoporosis.

I am glad I’ve stuck with my decision to get a second opinion. But I can’t shake the feeling I’ll come away from it more muddled than ever. This whole business of selecting the proper treatment is a gamble. Anyone for a game of Russian roulette?