Breast Cancer Index Test

Frostecat

Did your insurance cover it? Going through the process right now, and the test costs $5k, so nervous that my insurance won't cover it. I called the insurance company and got the run around about that it needs prior approval.

Moderators

Hi Frostecat!

You may find this information from the main Breastcancer.org site's page on Breast Cancer Index Test helpful:

Insurance coverage and financial assistance

The Medicare program and several other major insurance companies have agreed to cover the Breast Cancer Index test.

bioTheranostics, the company that makes the Breast Cancer Index test, has a Patient Advocate Team to help you with verifying insurance coverage and obtaining reimbursement. The company also has a patient assistance program that helps pay for testing. To contact the Patient Advocate Team, call 1-844-319-8111, Monday through Friday, 7 a.m.-4 p.m. Pacific Time. The email address is patientadvocates@biotheranostics.com.

We hope this helps!

--The Mods

Rae7200

Hi Frosecat! Grrrr. I was afraid I’d get a runaround, but my onco submitted it, and so far, so good. I haven’t looked at the EOB’s yet, though! 😉. So glad I go it. Mine put me at low risk, so I’ll only have to take tamoxifen for 5 years. It was like a huuuuuuge weight had been lifted off my shoulders, especially since I’d recently been diagnosed with lymphedema in my left breast and left upper arm. BC is the gift that keeps on giving. Knowing that this part of it stops after 5 years was really a mood lifter in a big, big way! Good luck to you

Fingers crossed for you that if your insurance doesn’t cover the test, that the patient advocate team that the moderators recommended will.

SpecialK

At the time I had the test done in 2016 this was the situation - if you had insurance and the BCI test was denied, Biotheranostics would handle appealing to your insurance company. Your oncologist did not have to do anything further, and neither did you as the patient. If your insurance continued to deny, and all appeals yielded no payment, Biotheranostics would absorb the test cost. My theory was that they were building the database to give the test more marketability. If you did not have insurance they also had a patient assistance program with a reduced cost.

Frostecat

I had someone call me from there prior to approving the test. She went through all of the scenarios, and in every one, she basically said somehow they would find a way to help me cover it, if my insurance does not. Conclusion is that I have met my deductibles and co-pays for the year so we are assuming it is covered. Time will tell, but if I can quit taking Arimidex, I will be a very happy camper. However, I don't want my desire to get off of the drug to put me at risk for recurrence, so if need be, I'll stay on it.

SpecialK, good to see you on here again and that you are doing well. You were a huge help to me when I was beginning this whole process in 2014 - thank you!

Peregrinelady

Frostecat, please let us know when you get your results. I am interested in what others are finding out. Mine was high risk, but also high benefit from continuing with the antihormonals. I am assuming because my tumor was fairly large and 100% ER driven. My Oncotype was 12. With your very low Oncotype and small tumor, I am curious what your result will be.

Bostoniangal25

ladies , can you explain me please about importantance of this test? We all premenopausal and taking Tamox after that we have to take postmenopous drugs like armidex- what exactly this test will show?

Mass general hospital stopped doing this test and ladies in their 40 they still recommend Tamox for 10 years! Thsnk

SpecialK

frostecat - hey hi!

Boston - this test shows the benefit of remaining on anti-hormonal medication beyond five years with a predictive and prognostic result by looking at 7 genes associated with your original tumor. The BCI Prognostic score estimates how likely the cancer is to come back 5-10 years after diagnosis. Scores range from 0-10. Cancers with scores from 0-5 are considered low risk, and scores from 5.1-10 are considered high risk. The BCI Predictive score looks at the benefit provided by taking anti-hormonals for an additional 5 years.

My result from this test was high risk of recurrence and low benefit from the drugs. This is an unusual result - only about 10% of test results have this arrangement, and my MO requested that I remain on anti-hormonals beyond five years, since low benefit isn't necessarily zero benefit.

Bostoniangal25

Thsnk you so much Special K , I feel bad they don’t do it much here but I asked nurse about it, later on ask about it my oncologist but I guess they want us to take it if we started at 40 to take it

Frostecat

Thanks for explaining this better than my Dr. SpecialK. They told me I should have the results in 7-10 days. My next appointent with my onc is in May 2019, so I don't think any changes will be made prior to then, as that will mark my 5 years.

SpecialK

frostecat - Do you have access to the results prior to your next appointment? If so, and you have not spoken to your MO about the result, it is really pretty straightforward for the majority of people. I will cross my fingers for a low risk for late recurrence. Decision making past 5 years becomes a cost benefit analysis - I know many are able to take anti-hormonals longer than 5 years with few side effects, but some struggle and have harmful SE so receiving a low risk result from this test does offer some peace of mind to stop. It is a hard decision and I know just recently extended AI anti-hormonal therapy for early stage node positives received an ASCO endorsement - link below.

https://community.breastcancer.org/forum/78/topics/868696?page=1#post_5319779

balance

Just a warning regarding payment for BCI test. I had mine done in 6/2017. My insurance paid it as out of network. Biotheranostics appealed to my insurance company, but they refused to change billing to in network. I was billed by Biotheranostics for a little over $1200 in 10/2018. They will pro-rate it if you meet strict income guidelines which I did not so I ended up responsible for the bill.

Agnes

Hello--I know I'm a little late to this thread, but I just saw it. I'm also newly diagnosed and am not familiar with this test. What is the difference with this test and the Oncotest? Is the Breast Cancer Index Test done later after a couple of years?

SpecialK

agnes - the OncotypeDX test determines whether there is benefit to adding chemo for breast cancer patients who have estrogen positive (ER+) tumors and assumes use of anti-hormonal drugs in the recurrence score given, while the BCI test determines whether there is benefit to continuing anti-hormonal therapy beyond 5 years. The OncotypeDX test is done at the beginning to help determine treatment decisions, while the BCI test is normally performed after one has been on the anti-hormonal drugs for 5 years. Both are genomic tests, performed on tissue from the surgically excised tumor, but they determine different things using different methodology.

Agnes

Thank you so much for clarifying. My oncologist never mentioned this test to me. I really appreciate you and this website for getting this information!

Frostecat

I just received my test results via My Chart, have not spoken or met with my Dr. yet, but I have a 2.6% risk of late recurrence. I about cried when I read this. Tears of joy.

SpecialK

frostecat - yay!!! That’s awesome

Salamandra

Deleted - wow, I'm really exhausted and confused about which thread I'm in 🙃

Peregrinelady

Great news, Frostecat! I would imagine this means that you can quit the antihormonals after 5 years. Let us know if the dr. gives you more info. Happy NewYear!

Frostecat

Yes, I will! Not sure if he will be calling me, or if I need to wait until May when I see him again. Who knows, they keep changing the criteria, so I hope nothing changes between now and then!

MDRR

happy for you frostecat!!

edwards750

Awesome Frostecat - I love MyChart. We know the test results ahead of time and don’t have to wait for the doctor to call. That’s a scary and often long wait.

My Oncotype score was 11. 8% chance of recurrence.

Diane

Frostecat

Yes, MyChart is great, but I have to admit I misunderstood the results one time. I confused a fibroid size for inches instead of centimeters, needless to say I was freaking out until I spoke with my Dr. :-)

Frostecat

Quick update. Had my oncologist appointment last week, and I am no longer on Anastrozole!!! I also had my mammogram last week and received the all clear letter in the mail!!

Regarding the Biotheranostics bill, my insurance company has rejected the $5,400 bill again. They did not consider it in network either. I owe $112 for miscellaneous things, but am still waiting to see if I am somehow stuck with all or a portion of this bill. YIKES!

herb

I had my BCI test last month. Score 7.8 on a 1 to 10. High Risk for recurrence but I show no benefit from added Arimidex after 5 year.. My insurance also rejected paying this. I am waiting for the re filing by lab. I am don't even care I am still in shock over my high score. really glad I had Chemo now.. Hopefully it got all those rogue cancer cells..

Peregrinelady

Herb, I am curious what your Oncotype score was if you had one. I had Oncotype of 12, but a high score on BCI. However, mine showed a benefit from continued antihormonal therapy. I, too, was shocked after having a low Oncotype.

mom2bunky

I wonder why one has to wait five years to do this test, if it's done on the original tumor? The tumor isn't going ot change, so why the wait?

SpecialK

The test is done at the 5 year point because the purpose is to determine whether to continue anti-hormonal therapy beyond that point. Five years of anti-hormonals is current standard of care, so the assumption of the test is that the patient will complete that therapy time period regardless,as that is what is always recommended at the outset as a minimum. Some patients discontinue taking the medications, or recur while on them, so doing the test prematurely would be an expense that insurance companies would not want to incur.

Peregrinelady

Mom2bunky, funny you say that because my oncologist ordered it for me right after diagnosis. I didn't ask him to, but I did mention it and he gave me the results during my first 3 month check up. It actually threw me back into a depression that I was just getting out of (from being misdiagnosed and Tamoxifen). Now I am glad he did because since the results were high chance of recurrence and high benefit from continuing the drugs, I am very careful to not miss a dose and although I have side effects, I will not quit unless they become unbearable. At first I could not comprehend how I could have a low Oncotype and a high BCI, but I think it has something to do with Oncotype being more predictive for the first 5 years and BCI for the next 5 - 10 years.

Peregrinelady

That makes sense, Special K. I am lucky that I didn’t have to pay based on my oncologist’s premature testing.

edwards750

A friend had the test done and her insurance company balked paying it 3x. Her husband persisted and theyfinally paid it. Why do they have to challenge these tests? They are vital to BC patients.

Diane