More than One Tumor - Oncotype/Mammaprint

britt330

For those with more than one tumor - did they do Mammaprint or Oncotype testing on both? We just met with my mom's oncologist, and she said they only tested the smaller tumor because it had less favorable hormone makeup (low progesterone...both tumors are highly ER+). But she said ideally they would have tested both, because the second tumor came back at 4.5cm when imaging only guessed it to be 2cm. The tumor that had Mammaprint came back with very low risk of recurrence--less than 1.5%. However, I feel like we don't have all the information to make an informed decision about chemo. And we can't delay radiation to get test results back.

I'm so upset, I feel like they really failed her and I'm looking for other care, even though we're apparently at a top cancer center. They should have sent a second sample to Mammaprint the moment the pathology report came back at 4.5cm.

SummerAngel

I had two tumors and only had an Oncotype test on one (the larger). A second opinion oncologist at a top cancer center (top 10 NCI-Designated center) told me he would only have tested the larger as well, but the few studies I've found on the subject suggest that the result can be different enough to change treatment (chemo or no chemo), especially in younger women. My MO said that he would send the second tumor for testing if it would change my mind about treatment if it came back higher risk. I declined. So the question is: Would your mother's treatment change if you had the second tumor tested and it came back higher risk?

It's not too late to have the second tumor tested, by the way. You could insist.

britt330

The problem is - she HAS to have radiation because she has a positive posterior deep margin. So there's no grey area there. They can't delay radiation unless she chooses chemo. But how can she choose to take the risk of chemo when her other tumor came back so low-risk?

SummerAngel

If the test on the first tumor came back low risk, she can demand testing of the other tumor. Yes, there would be a delay in radiation, but she could do it. She will need to decide if she thinks it's worth testing the other tumor or not. Typically, older women don't have tumors that result in very different genetic test results, but it is still up to her whether she wants to delay radiation and go for additional testing.