When is it a good idea to NOT get the oncotype test???

Sherri_V

My dr. says I don't need it in my case (colloid/mucinous carcinoma).

I don't see her again until next week now (rescheduled) but I'm curious and hate to wait but don't want to bother her with what may be a trivial call.

Please let me know if you KNOW why I would NOT need that test.

Thank you!

Jaimieh

I believe you get the oncotype if you are er/pr +  with 0 or very few nodes involved.  So if you are er/pr- then you would not need the test.  I hope you get some answers next week.

MarieKelly

Sherri,

There's probably a few different reasons why you don't need the Oncotype test. First one being  the size of your tumor. Despite it being well differentiated with a pure mucinous/colloid having an overall very good prognosis and much less likely to become metastatic, even at that size, than a higher grade tumor, many oncologists would be inclined to prescibe chemotherapy for a 3 cm + tumor - if for no other reason than ' just in case' and because it's what they're comfortable with doing. Since the Oncotype test is primarily used to decide whether chemo should be given in cases where it's questionable if chemo would be beneficial or not, it really wouldn't need to be done on someone with a larger size tumor who has an oncologist that automatically prescribes chemo for any tumor over a predetermined size.

Another possible reason your oncologist might not feel Oncotype testing is necessary is if she happens to be one who recognizes the relatively low metastatic potential of your type of tumor, regardless of it's size, and therefore doesn't have any intention of prescribing chemo because she doesn't feel it's warranted. If she's not even considering chemo for you, then ordering a test designed to help her make a chemo decision when she's already decided is a moot point. Chemotherapy works best on rapidly dividing tumors, and a grade 1 is moving at a snails pace in comparison to hgher grades and therefore unlikely to benefit much, if any, from chemotherapy. Hormonal therapy alone has been found to generally be a much better choice for many hormone positive tumors.

Another possible reason why she might not consider Oncotype testing necessary for you could be because she simply doesn't feel confident in the reliablility of the test itself - some oncologists aren't convinced and still prefer to base their chemo decisions on clinical judgement.