Variance in Clinical information , Oncotype and Mamma Print

OTY

My Oncotype came back as 26 yesterday . Oncologist was surprised as clinical pathology indicates a less than 2 cm indolent ILC . In fact along with very low Ki 67 and mitoitic rate less than 2/10 , adjuvant therapy is radiation and tam +AI . Fortunately had done Mammaprint as well and that come back low risk so decision on chemo was to avoid .

I read a report on a nomogram on the net which had a calculator which clearly suggests that based on clinical information for my case there is 99 percent chance that Oncotype score should be between 0 and 17 and 91 percent chance it should be between 0 and 10.

My oncologist doesn't seem to be able to explain and I am worried if they sent the wrong tissue sample . What could be an explanation for this ?

Meow13

I also had a high oncodx that suprised everyone given the pathology results. I only received one score even though I had 2 tumors. My score was 34, I didn't do the recommended chemo I took 4 years AI drugs. So far so good. They weren't offering mamoprint at that time.

OTY

thanks meo

CindyNY

Onco score of 26 is still in the "gray" area, unknown if SE outweigh benefits of chemo. The MammaPrint is high or low, no gray area. I can't say with any conviction that a wrong sample never happens, truly no idea. Your oncologist has you moving forward with radiation. Not sure what else to say, but I think you're on the right plan going forward. Best wishes to you.

OTY

thank you cindy

Earlyanna

Hello,

Thanks for sharing this info. Any chance you could post a link to the Oncoscore calculator? I've been searching for one, but haven't been able to find one.

In health, Earlyanna

keepthefaith

OTY, you could always get a second opinion, but having a Grade 1 tumor( which don't respond as well to chemo as higher grades), I would think your MO is on track with a good treatment plan. Do what you think is best. Your mamma-print and onco are confusing though! My onco was a 21 and I never got the MP done, but my tumor was a higher grade than yours. Best wishes moving forward!

mightygnat

Maybe this is the calculator she used:

https://gsm.utmck.edu/nomograms/

OTY

hi thanks mightyknat . This is the is the university of Kentucky nomogram

OTY

thanks keep the faith . It is is indeed confusing . But with the clinical results and the the mammaprint , we can take a decision . As you correctly pointed out , with a luminal A and Grade 1 , any chemotherapy benefit will likely be low

OTY

Thanks Early Anna . The calculator correlating the pathology score and the oncotype score is available under a section Oncotype Tools whicich is available only to the oncologist . I only got a report .

Meow13

My risk of getting a score 31-100 on the oncodx test was 23%, I got a 34.

keepthefaith

That nomogram was interesting. I got a predicted low score. I was on the lower end of intermediate. I wish the TailorX intermediate results would be published soon.

DebAL

This may be a silly question, but do most of you ladies go by your path report or oncotype when it comes to how you consider your hormone status? My path report has my PR at 3%..very low but anything over 1% is considered positive. Oncotype has PR at 5.4 which is neg, 5.5 is positive (ER positive on both path and oncotype) On the bubble...story of my life! Lol

Meow13

DebAl, my numbers were close on pathology vs oncodx. My biopsy results said the tumors were both ilc, pathology after mx had one ilc and one idc. My pathology report seemed very detailed I believe it was not in error. I am not so sure about the oncodx. You know for $4000 you would think it would supply more information on arriving at the score. It did have er+ 94% instead of 95% and pr-.

ChelseaSculler

That nomogram is fascinating—I had a 98% chance of not being low risk and found out yesterday my oncotype is 22. I was shocked, totally hadn't expected that. Chemo suddenly ended up back on the table.

So now we're waiting—the TAILORx results are being announced June 3 and the oncologist suggested we wait it out.

Fun times!

PalBuddy

I got my Oncotype score (19) the day after the TailorX study was published...So, I'm not doing Chemo.

My ER+ is 60% - does anyone know if the percentage indicates how well AI's will work? Is there a study on that?

Thanks.

Meow13

PalBuddy, very good question about % hormone. I always just assumed the higher the percentage the better it would work. Even with very low hormone percentages I see people being prescribed hormone therapy. I think it is suppose to be an element in determining your oncodx score. For me ER was 95% but PR was zero bring my oncodx score to 34. But it could be a more concerning cancer when estrogen is present but no progesterone.

OTY

The Tailor X trials at ASCO 18 was a milestone . Anxiety at a personal level though . Medical Oncologist said no chemo based on Clinico pathological parameters and again after evaluating Oncotype score 26 and Mamma Print Low . Have finished radiation and a month into adjuvant hormonal therapy Took two second opinions a month before Tailor X . Dana Farber endorsed above opinion and said no chemo . Sloan Kettering said no chemo fine but I could wait for Tailor X and still do chemo as lumpectomy done only 3 months back . Age 45 which Tailor X s could benefit from chemo in scores of 15 and above .But early menopausal at 42 so will that really apply in this case?

Distressing!

Meow13

Your tumor was grade 1, are you worried because of your oncodx score of 26? Not sure chemo would help you being lobular and grade 1. I would want to get on hormone treatment ASAP, if you do chemo they probably would take you off hormone therapy which could be a mistake in your case. Very frustrating treating cancer.

OTY

Thanks Meow . Yes the Oncotype score is the one worrying me . I have started hormone therapy 3 weeks back and so far handling it well . You make good points about the tumour grade and ILC . This 18-25 cut off at Tailor X has made it all the more complicated . Subsequent slides shown at Asco basically distillate one part of the Tailor X study as showing that for Oncotype 25 to 30 for post menopausal women adding chemotherapy is a question mark ie they don't know .