Oncotype - advice and timing please

Before I was dx with BC I set up an appt. with a BS. I had already had a mammogram that showed something that looked suspicious. When the final determination was in after more digital views,US, stereotactic biopsy I had the appt. with my BS and we scheduled a lumpectomy. After surgery and after learning so much from this board I asked about the Oncotype DX. I told the lab to go ahead and send the tumor out for testing. I'm on Medicare so money wasn't a problem. Medicare covered the expense. Between my surgeon and I it was decided, no chemo. My score was a 5. Later I had an appt. with an oncologist, then started radiation for 33 tx. Have 20 more to go. I will go back to my oncologist when rads are finished to decide if I go on Arimidex or Tamoxifin.

You're a little like me, I think Lories. My surgeon knew about Oncotype DX and we discussed it before surgery. He said I was a likely candidate. I turned up node positive, which essentially disqualifies me, even if premenopause doesn't--but we didn't know that until after surgery. You're doing the right thing by going ahead with it.

After that, you should be turned over to the brilliant Oncologist of your choosing. He's the guy that actually orders the test. He's the guy that sort of co-ordinates your plan of attack. You'll see a radiologist too, but that's later. After surgery, you've got to figure out the big picture plan for you.

After that, you see whatever doc is appropriate for your plan. Radiologist in there somewhere, probably, if you go lumpectomy. Your Onco will tell you when it's time.

First things first tho. Don't forget to breathe.

I'm 11 days out of lump/SNB and 8 days out of ALND. Meeting with my new (1st try anyway) Oncologist 1/6, so I'm just ahead of you in this process, I think. Drop me a line if you need to bend an ear for awhile. I'm movin' a little slow. But I'm movin'.

You can do it too.

Best Wishes,

Webbie   

P.S. I'm reading that trials are being done on the possibility that it can help early stage node invasion recurrance predictions as well. Hubby and I may pay out of pocket if we think it will do some good.  

Hi, Lori ~  It sounds like you are getting good advice from both your surgeon and the other ladies here.  If I understand your scenario, once they have the MRI and are certain nothing else is going on in either breast, then your surgeon will proceed with surgery, which will probably include a SNB.  If the bc has not gone to your sentinel node and he gets clean margins on your lumpectomy, the chances of needing chemo will depend on factors about your bc that the surgical pathology will disclose.  If chemo is not recommended, once healed from your surgery, you would most likely move directly into radiation. 

Oncotype testing is done if the question of whether or not to do chemo is borderline or not clearly agreed on by all involved.  So, you will need to have your surgical patholgy results inhand to understand the recommendation(s) for or against chemo.

At this point, unless you are at a comprehensive breast center where all specialists are under one roof or at least one medical center, what you might do is start asking people for recommendations for both an oncologist and a radiation oncologist.  That way, when it's time to move ahead, you'll have the doc you want to interview in mind.  Unless you're in an extremely busy area, getting app'ts. with those docs is usually pretty quick, once you have all your reports and are ready to move into their area of expertise.

Good luck, and please keep us posted ~  Deanna

Hi, I have a question....... I was diagnosed with Leukemia 4 years ago and went through the horrible ritual of the intense chemo, etc. and have been in remission for the last 4 years. I have only been off all meds for the Leukemia only 6 months when i was diagnosed with Breast Cancer. It was classified as IDC and I had a lumpectomy and a sentinel node biopsy which turned out clean. I understand that I am estrogen receptor positive. My surgeon had referred me back to my original oncologist, whose specialty is Hematology, although he has treated breast cancer patients in the past. He is running the Oncotype DX test. I have to see the surgeon and my oncologist on Jan 6th and I have already met with a radiologist for radiation treatment. Haven't started that yet. My question is----- my oncologist seems to be up on the BC stuff but should I consider going to a Breast Cancer only oncologist, if there is such a thing, or if I have any doubts syggest to him that he/we consult another doctor?



He has mentioned Tamoxifen to me but I am post menopausal as I was forced into menopause from the radical chemo I had gone through. I haven't has my period since Sept 2004.

I am terrified of all this stuff, worse than with the Leukemia. Can anyone help elaborate on some of this stuff for me. I would be very appreciative of any help.

Thanks, Michele