Oncotype Scores

Texasbluebonnet

Hello all, I'm new here. My surgeon got the results of my Oncotype test for DCIS,and my score was 70. As I read through various posts, I don't see anyone with a score nearly that high.

Are there any others of you out there with a score like that, and what did your oncologist say about it?

Thank you

doxie

That is much higher than most. What % was your ER and PR? Have you been tested to see if you are HER2+?

Texasbluebonnet

Hi, thanks for responding

I am 95% ER positive, but not sure about PR score. No mention of HER2.

With an Oncotype score so high, I'm feeling rather deflated about my whole future. Going through surgery, radiation, and dealing with side effects of Femara with a sinking feeling it'll come back again.

Moderators

Dear Texasbluebonnet, We are glad that you reached out to our community, although we are sorry about the worry around you Oncotype score. Here is some more information for you to read from our website about oncotype testing. Keep us posted and stay connected here. It is a great place to get support, especially around worries and concerns.

BarredOwl

Hi Texasbluebonnet:

I apologize in advance if you are already aware of this. The Oncotype test for DCIS is not used as much as the Oncotype test for invasive disease. There are fewer people on the boards that received the DCIS test, and they may not be a representative sample of the distribution of DCIS scores.

Note that the tests for invasive disease and for DCIS differ in the number of test genes used, they are used in different patient populations (different "eligibility" requirements), for different purposes, and their recurrence risk ranges are also different.

Because of these differences, if a person has invasive disease (e.g., IDC, ILC), then the test for invasive disease is used, and their Recurrence Score cannot be compared to DCIS scores.

For example, the test for invasive disease uses 16 cancer-related genes and 5 reference or control genes ("21-gene test"). It is used in patients with invasive disease that is hormone receptor-positive, HER2-negative, regardless of type of surgery, to inform decision-making regarding chemotherapy (endocrine therapy alone or endocrine therapy plus chemotherapy).

In contrast, the test for DCIS uses 7 cancer-related genes and 5 reference genes ("12-gene test" (a subset of the genes used in the invasive test). It is used in patients determined by surgical pathology to have pure DCIS (no invasive disease) and who are treated by local excision (also known as breast conserving therapy or lumpectomy) (with or without tamoxifen), to aid in decision-making regarding radiation therapy. Eligibility for the DCIS test does not require any particular receptor status.

The standard risk categories for the test for invasive disease are:

Low-risk (Recurrence Score < 18)

Intermediate-risk (Recurrence Score 18 to 30)

High-risk (Recurrence Score ≥ 31)

In contrast, the standard risk categories for the DCIS test are different, with "high risk" starting at a higher score:

Low-risk (DCIS Score < 39)

Intermediate-risk (DCIS Score 39–54)

High-risk (DCIS Score ≥ 55)

It sounds like you have selected a treatment plan that addresses the risk information provided by the DCIS test, which is good.

Best,

BarredOwl

References:

Rakovitch (2015): http://link.springer.com/article/10.1007/s10549-015-3464-6/fulltext.html

Solin (2013): http://jnci.oxfordjournals.org/content/105/10/701

Texasbluebonnet

I am so grateful to you for taking the time out of your day to reply with such a thorough explanation. Thank you!

Such kindnes

Meow13

TexasBlubonnet, I hope you feel better. I received an oncodx of 34 in the invasive cancer test. The high number is so upsetting but I hope you feel better about the 70 score in non-invasive test. You are going to be fine! Do not let the number scare you. It is to help you make treatment decisions, you will be ok.

Ld1315

Texasbluebonnet,

I just got my score today. It was 72. I already had a double mastectomy Feb 2015, but I wanted to find out everything I can about the DCIS I had. I'm only 42 and have been resisting taking tamoxifen. I'm not sure what my doctor will say now. I hope you are on your way to figuring out your treatment plan.

Texasbluebonnet

Thank you for your positive words, Meow. The community of support from fellow survivors is a blessing.

Texasbluebonnet

Ld, sorry to hear that you also have a high score. We're in the same boat. Hope you can meet with your oncologist soon to discuss Tamoxifan

I'm meeting with my oncologist next week to discuss my score and see what he says about my odds of recurrence. I'm planning to stay on Femara indefinitely