Oncotype Dx test...

Dejaboo

Joni0702- Did you end up having the Onco test done?

I just read through this thread & Found this

"21 Feb 2008 09:12 AM

If I'm not mistaken, the Oncotype recurrence score is based on the assumption that you will be getting tamoxifen or an AI (such as Arimidex), whichever is appropriate.  I think the Oncotype test was originally designed to tell whether women with estrogen-sensitive tumors would do well on tamoxifen alone, or would need regular chemotherapy in addition to tamoxifen.  That work is being expanded to include aromatase inhibitors (AI) instead of tamoxifen in post-menopausal women.

I don't know how radiation therapy fits into your treatment formula.  The Oncotype system assumes you've had surgical removal of the tumor, either by mastectomy or by lumpectomy+irradiation.  If you had lumpectomy, you will most likely need irradiation anyway--that's pretty much automatic. 

What do you think you will do, with a score of 20?  I'm waiting to hear what my score is--it was just submitted a week ago."

I didnt know that the test was based for women who planned on taking Tamoxifen or an AI.

Is the test not really a good indicator if you arent going to take Tamoxifen?

I had a TIA (mini Stroke) 9 years ago...So I do not know if Tamoxifen would be safe for me...I am having a Bubble Echo on Monday & that should help me decide...But isnt 100% to say it would be ok.

otter

Dejaboo,

That was a post of mine that you quoted.  Yes, the "recurrence score" provided by Genomic Health with the Oncotype test is based on the assumption that you'll be getting tamoxifen (or an AI if appropriate).  The risk of recurrence would be considerably greater if you don't get an estrogen blocker.  Genomic Health has a lot of information on their website explaining the Oncotype test and the scientific background supporting it.

There is also a website called "AdjuvantOnline" where you can calculate your risk of recurrence with or without a whole bunch of variables, including estrogen blocker (tamoxifen) and/or chemo.  You have to register to use the website, and they say you're supposed to be a "health professional" but they don't check credentials.

Could you take an AI instead of tamoxifen?  (Are you menopausal?)  I don't think AI's have the cardiovascular risk (clots, strokes) that tamoxifen does. 

otter 

wishiwere

Otter, I just realized I missed your post asking for clarificaton about genome paying for the test if you insurance didn't.  As far as my discussion with them and the papers I signed, yes, that is what I was told, signed.  IF my insurance denied it, they (genome) would appeal it and if they lost the appeal, there would be no payment for me.  I assume that it's still like that, but uncertain, as I heard as of late, it was being accepted by more if not most insurances now.

mom909398

I JUST GOT MY RESULTS FROM THE ONCO TEST I SCORED A 15 ......STAGE 1 GRADE 1 NODE NEG ER POSITIVE/PR POSITIVE, HER2 NEG.  MY DOCTOR IS SUGGESTING RADIATION, TAMOXIFEN AND LUPERON WHICH IS AN INJECTON HAS ANYONE EVER HEARD OF IT????   THANKS

darshan

first you checkup with doctor  or Simple test( PAP Smear) for onco if it is positive then you take decision

j21942

My wife was recently diagnosed with DCIS.  Turns out she had to questionable sectors and she opted for a masectomy of her left breast.  The pathology report indicated an 8mm, slightly invasive (grade 1) tumor that was ER & PR + and HER2 -.  Her Oncologist recommended that she do the Oncotype DX test which indicated a score of 30.  After doing much research into her particular situation and discussing the results with the Onclologist, she opted to go with Arimidex therapy to reduce production of ER without adjuvant chemo.

The decision making process to chemo or not chemo is very confusing.  What you need to evaluate is what your propability of recurrence is without chemo and then evaluate the reduction in recurrence probability with chemo against the negative impacts of chemo for that additional reduction.  In my wife's case, adding chemo therapy would have reduced her recurrence probability by maybe o1 or 2 % which she didn't feel would offset the potential harm caused by the chemo.

Hope the above helps you evaluate your particular situation.

 Good luck!!

Emily2008

mom-

lupron injections are designed to stop ovarian production of estrogen, thereby reducing your chances of ER+ tumor growths.   

DEAIndiana

I am 46, premenopausal...Stage 1 breast cancer, 1.5 cm, estrogen and progestrone positive, NR2 negative, grade 1, no lymph node involvement and clean margins. I had to ask the surgeon to send the sample for the Oncotype DX test. When it came back my score was a lucky 16. I asked the chemotherapy dr and she said, based on all my other information she could not recommend chemo. The LONG term side effects were not worth it. I asked her would she do chemo and she is in her late 30's she said no. I am very comfortable with my decision! I had a lumpectomy and am going through radiation right now!

hopefullady

I would appreciate any advice, although I know that ultimately I have to make a decision.

My tumor was 1 cm, had lumpectomy and mammosite radiation.  I just had the Oncotype test and it came back 20.  My oncologist is recommending chemo and today I had a PET/CT scan and MUGO.  

Tomorrow I have labs and another visit with the oncologist.  I have not been able to make a decision.  He said a 13% chance of recurrence with just tamoxifen and with chemo lowered to a 6% chance.  Friends have given their opinions, but of course, they have never been in this situation and the results are about half each way anyway.

One day I think that I should have chemo and know that I have done everything possible to improve my odds.  The next day I think that I should not put a fairly healthy body through chemo when they said they got it all, clean margins and no node involvement.  

How do you decide what to do??

Chris 

jude14

Hi SKHUNT....my onco score was 18 and I was a stage one with a grade three....my onco told me the benefits of the chemo would not benefit me with the risk of the chemo.  He told me if I was his mom, I am 58, he would tell me to skip the chemo and see what happens.  I did the rads and doing femara right now....

Harley44

hopefullady,

Another factor you must consider is your age... if you are young, it may still be a good idea to get chemo, since you will have many more years for a recurrence to occur.  At least, this is how my surgeon explained it to me.  He was pushing me to get chemo, but I didn't want to, because I thought it was just too risky, and there are too many se's from chemo.

I was 44, and I have to say that after I decided to go ahead with chemo, I felt much more at peace with my decision.  It has been a year since I had chemo (started 8/7/07) and I have to say that it is very doable.   I am the biggest chicken, and if I could do it, so can you.

Good Luck with your decision!  Whatever you decide, I'll be right there with you.

Harley

Sam91

Chris

I also had a score of 20 - had two opinions - the first said chemo the second said it was my choice as the benefits wouldn't be that great - but who knows!!  I opted to join the TailorX clinical trial and since I was in the intermediate range they chose for me.  I was chosen to take tamox only.  I will be followed for the next 20 years.  I see my onc every 4 months.  

I agree it is a tuff decision but one that only you can make.  Good Luck 

Anonymous

I just got my test score back this afternoon...a 24...so I'll be starting chemo next Wednesday...I'm just happy that treatment is finally happening....!

hopefullady

I have decided to go with the chemo, just for my peace of mind.  

One of the hardest decisions I have ever made.  

If feels like the right one, though.  

 Thanks for the help.

Chris 

123JustMe

bump