Oncotype score-what is a factor? Plz help me predict

HereToHelpMyMom

Hi All,

We are waiting on my mom's oncotype score. Her pathology was such a mixed bag that i don't know what to expect. Even if chemo is recmd'd, because she is 80yo, I dont know if she can handle it. So, Im basically sitting at my computer worrying. Here is the pathology from her mastectomy:

• 2.2cm, IDC (A surprise. Was thought to be 1.4cm before surgery)
• 99% ER+, 99% PR+
• HER2 negative (+1, 20%, "SISH results pending".......what does this mean? isnt negative "negative")
• grade 2 or 3 (pathology report lists it differently on different pages!!)
• No LVI
• LCIS classic type and non-extensive DCIS also found in same breast
• Ki-67 is 3%

im thinking that the possible grade 3 is the highest indicator of a high onco score, but hoping that the 99% ER/PR status helps, as does the low Ki-67.

Anyone with a similar profile or thoughts?

Thanks and feeling grateful to to have found this community. Best wishes to all

HereToHelpMyMom

I forgot to mention: 0/1 node

Beesie

While there could be a surprise, the high ER and PR percentages along with the low Ki-67 would suggest the likelihood of a low Oncotype score.

Given your mother's age, a higher score would still present a relatively low recurrence risk, although that might not be reflected in the generic report that comes with the score. Even the Oncotype folks know that age matters when it comes to recurrence risk, and they have a separate program that Oncologists can use to add age (plus grade and tumor size into the equation (Oncotype RSPC). Using this model, your mother's age will significantly reduce her risk of mets as compared to someone 30 or 40 years younger with the same score. I'm actually surprised the Oncotype test was done, given the favorable pathology and the ER+/PR+/HER2- status. The benefit of chemo is not established for older patients, particularly those with favorable pathology. See the NCCN Guidelines here: