Oncotype DX test and chemo questions?

Same here as Pam.  My Oncotype (ins also paid for it) came in at 13 (or was it 11?) and chemo was not indicated.   My med onc would have gone along with it if I had wanted to do chemo anyway but I am okay with my decision.  Did 33 rads and have been on Arimidex for 13 months now.  It is really very personal the choice you make for yourself as you have to be comfortable with it. 

I don't know about being able to do the same chemo, but thinking probably you could. What stage are you? If you are Stage I with a lower grade tumor, I would say that the Oncotype would be a good idea  for sure, because it would give more peace of mind (if it's low you could feel good about skipping chemo, if it is high, then you'd feel like you would be making the right choice by doing chemo; if it's in the middle you'll be back here asking more questions!). Best of luck. Ruth

Yes the oncotype did influence the chemo decision in my case.  My score was 23 - I was 44, so I did CMF -which is a very tolerable chemo. Life YramAL I had decided that I would do chemo if I landed in the gray area, and that is where I was -

Certain chemos are once in a lifetime - I can't remember the term but there is a term that they use for chemos that you can only take once.  First tier?  That may be the term.  Adrimyacin (sp?) I believe you can only do once.

Oncotype is a very helpful test - I havve seen grade 1's with higher oncotype than mine, and grade 3 with lower so you really can't just use your grade to assume your score.  My stats look the same as YramAL, but more score was double. 

My insurance covered it.  Genomic Health who does the oncotype said that they help patients appeal insurance denials if that is a problem - I think most insurance in the US covers it. 

 Good luck with this!

Get the test, and hopefully then it will be very clear what to do. Unless it is LOW, you probably will want to opt for chemo with how goofy things have been so far. Good Luck! Ruth

I've never quite gotten why some insurances won't cover the Oncotype test. In my case, the Oncotype test saved my insurance thousands of dollars that they would have had to pay for chemo. 

Mary 

Yes, my oncotype influenced my decision to do chemo.

I saw 2 oncologists who, based on my tumor size, grade, etc did not recommend chemo, unless the oncotype score came back high or intermediate.

Well, my oncotype score was 21, which is intermediate. So I did 4 rounds of Taxotere and cytoxan. Without the oncotype test, I would not have done chemo. With the oncotype test, it was clear I had to do it.

Get the Oncotype test. This is the latest technology and analyzes 21 genes from your tumor. According to my oncologist, it supersedes everything else.  

Hello Roberta,

I think you do not need a port for 4 rounds of chemo. Who told you you needed one ?

My oncotype was 21 and I did 4 rounds of Taxotere and Cytoxan every 3 weeks. Except from the fatigue, weird taste in mouth, and hairloss, I did fine on it. I never once took my nausea medication, I just never felt nauseous! I did have steroids to take on day 1, 2, 3 and 4 after chemo. They made me very hungry! I did not have a port.  

The hardest chemo round was, psychologically, chemo # 3. Nothing to look forward to for chemo 3 compared to the other rounds.

Chemo 1: you do not know what to expect so it goes by fast; Chemo 2: you are happy you are halfway through; Chemo 4: you're happy because it is the last one.

I wish you the best, I hope everything goes well!

Hello Roberta-My score was 25 ( 16% recurrence)  I did 4 rounds of Taxotere and Cytoxan every 3 weeks. I worked full-time the entire time. (except for treatment day and I missed 2 days of work on day 9 and 10 after my 1st treatment.  I picked up a viral infection.) A shot and  iv of fluids did me good.  Its a very tough decision.  I decided to do chemo because i was 44.( 1 week before my 45th b-day)  

Ask about doing dose dense two weeks apart with the Neulasta shots. Dose dense means you can get it over with quicker; for may be slightly more effective than the 3 week route. I did 4 rounds of chemo and taught school all through it, only missing infusion days (I had mine of Fridays, so that I'd have the weekend to recover). I had a port, which I didn't like at all, but it does save the veins. All yucky but doable.

My Proliferative-low proliferative (Yeah)  I guess it doesnt matter the size of the tumor,sometimes.  

Grade is a huge indicator.  High grade usually means higher risk.  But, I broke that rule with a 12.  From what my onc says, the Tailor X trial is going to present a whole new way of considering the weighting of Oncotype.  Until then, we just aren't quite sure.  I went from low, to intermediate risk, simply because the trial changed the risk ranges.  A lot of oncs were puzzled and pissed by that.

She also indicated there are hundreds of genes, something like 630 to be studied.  We have such a very long way to go to get the full picture on this stinkin' disease!

I did really learn a lot, though, in studying recurrence.  There is a huge difference between recurrence and what is basically a body's predisposition to breast cancer.  My doctor spoke of curing my cancer.  She can do it in all likelihood, that is, THIS cancer.  Getting a local recurrence or new breast cancer, well, that's a whole other issue. And one not often talked about....

Kira - I called genomic health to track my oncotype tissue sample.  Mainly, I wanted to make sure that the onc had the actual score prior to my appt.  They are REALLY nice - of course would not tell me the score but did tell me when they sent the information to my cancer center.  Do a search on Genomic Health - I believe they are in Redwood City, Ca.  Grade 1 would typically indicate a low oncotype score, but seriously I have seen women with grade 1 have high scores, and grade 3 have lower scores.  Good luck with this!

April,

Thanks for the suggestion. They were very nice, and low and behold sent to the Dr. 2 weeks ago. Got a call 5 minutes later from his office, and guess what they have the reports. I will be picking them up later today.

Karen

aprilgirl1

 I have seen the same. I have seen women with grade 1 have high scores, and grade 3 have lower scores.