Oncotype DX for DCIS

LisaDCIS

How many have had the radiation oncologist request the Oncotype for DCIS? I'm 40, had 1 small area DCIS (8mm) of grade 3 w/ comedo necrosis removed with clear margins on a lumpectomy. I requested the Oncotype for DCIS to help me feel "better" about having radiation, as I am very worried about the long term side effects. My score came back as a 6. So very very low. The ordering rad onc said hey- your recurrence risk based on this test (that he doesn't order often) is only 8% without radiation. That is actually less than my original recurrence risk with radiation before I had test results. He said that radiation was totally up to me based on that, and he really had no recommendations.

I have another appointment with another rad onc in a different healthcare system this week, but I already know she is against Oncotype for DCIS for whatever reason. Perhaps as it is not yet the golden standard here in the US.

I also have an appointment with the oncologist (mine is ER/PR+) to discuss her thoughts as well.

Has anyone made decisions with grade 3 DCIS based off of the Oncotype for DCIS?

Michelle94904

I'm in Marin County CA and Oncotype DX testing is standard procedure here, it seems. Waiting for my results (expected them last Friday the 13th...) Will circle back when I have more to share. Sending support and healing thoughts.

Beesie

Michelle, the Oncotype DX test for invasive breast cancer is very different from the Oncotype test for DCIS (unfortunate that the tests have the same name). The invasive cancer test has been around longer and has been incorporated into invasive cancer treatment protocols. That is not the case with the Oncotype DX test for DCIS.

Lisa, I recall that when the Oncotype DX for DCIS first came out, there were questions as to whether it should be used when the DCIS is grade 3 because the patient group involved in the original test validation was quite small.

A Multigene Expression Assay to Predict Local Recurrence Risk for Ductal Carcinoma In Situ of the Breast

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653823/?report=reader#!po=35.0000

.

More studies have been done since which seem to support it's use, although frankly it seems that the Oncotype DX for DCIS has never really gotten off the ground. From reading here, it seems to rarely be suggested by doctors but more often is requested by patients. Some of the other studies/articles:

SABCS 2014: Oncotype DX DCIS Score Reliably Predicts Breast Cancer Recurrence in Patients With DCIS

https://www.ascopost.com/News/20672

• Study abstract referenced by SABCS 2014: [S5-04] A large prospectively-designed study of the DCIS score: Predicting recurrence risk after local excision for ductal carcinoma in situ patients with and without irradiation

https://www.abstracts2view.com/sabcs14/view.php?nu=SABCS13L_1347&terms=

.

A population-based validation study of the DCIS Score predicting recurrence risk in individuals treated by breast-conserving surgery alone.

https://www.ncbi.nlm.nih.gov/pubmed/26119102

.

Abstract P5-18-12: Effectiveness of Oncotype DX DCIS scoring in a community setting

https://cancerres.aacrjournals.org/content/79/4_Su...

LoveFromPhilly

Beesie thank youuuu sooo soooo much for your amazing research with DCIS. I have a dear friend who has a new diagnosis and is being told mastectomy and going for a second opinion. She is a very educated woman and versed in medical research, and has requested the oncotype test for DCIS. And you are correct, the breast surgeon said that it isn’t typically done but they agreed to it thankfully. We shall see what all the results show and how she plans to move forward.

Your information sharing has been invaluable to me! I hope one day my friend feels comfortable enough to join BC.org but for now she doesn’t want to go onto these boards. It is so overwhelming at first!!!

Hugs,
Philly 🌟🌟