Oncotype DX and other tests...

Chirps · August 2010

I will be meeting with Med Onco tomorrow. Had BMX on 8/10 for IDC: 1.3cm HR+/PR- HER2neu- Grade 2, nodes 0/3.

Does it seem likely that an Oncotype DX could be helpful?

Are there other tumor tests that might be helpful?

My ER+ is only barely positive (please see http://community.breastcancer.org/forum/108/topic/757156 ) and I'm not sure if Tamox will do much good (we'll discuss this I'm sure).

I also wonder about tests to look for mets that have "no obvious outward signs." Are these typically done or typically not? Which are the most important? The whole point of post-surgery treatment, as I understand it, is to kill the cancer cells that have moved away from the tumor's location. If this is presumed to have occurred, it would make sense to look for any mets that exist. It's much less likely to have mets if 0 or few lymph nodes are positive, but it's certainly not impossible.

I'm trying to learn as much as I can before meeting with the MedOnco... I really appreciate any answers and links to more info!!

Claire82 · August 2010

My onc doesn't do scans or blood tests unless there is some sort of symptom. She said that there are too many false positives and then they have to do other tests which are dangerous in themselves. I am stage 1 with no lymph involvement. I had taxotere and cytoxan for my chemo treatment.

workmother · August 2010

I am also "barely" positive. Technically I'm triple negative because it doesn't register as a true positive. The Oncotype test usually isn't done on triple negatives. I had it done because there was conflicting pathology if I was ER positive between my original biopsy and my lumpectomy. The Oncotype came back as weakly positive. It also showed a high recurrence (32% - YIKES!). But I'm grade 3. That recurrence number made a big impact on me. I knew I had to go the chemo route. I'm doing dose dense AC (4 rounds) followed by dose dense Taxol (4 rounds), then radiation.

Like Claire82, my onc doesn't do the scams or blood tests either for the same reasons. Good luck to you!

Chirps · August 2010

Claire82 - thanks for your response. Makes sense, if there's a high rate of false positives and many tests pose risks; I had feared it was moreso "just" a cost thing. If you don't mind my asking, were you told a % risk of recurrence (in the absence of chemo)?

workmother - thanks for answering. I had no biopsy path for receptors b/c they ran out of tissue just trying to figure out whether it was ductal or lobular. Wow, your 32%, that's some motivation all right! Do you recall how your "barely positive" ER was expressed --- a percent or an Allred score?

I just read in a research report that HR status can change (from + to - or vice versa) after a neoadjuvent chemo treatment! In this case, it was 23% of the time. Not sure what all this means, other than I definitely understand less than I thought I did, about this ER stuff! Hmmmm...

I thank you both again and wish you all the best in your treatments!!

Chirps · August 2010

Just to follow up, my MedOnco said my "barely positive" ER (2 of 8 on Allred scale) is so miniscule that he thinks hormone therapy wouldn't be very helpful. He didn't say I'm triple negative, but I didn't ask specifically. He did say that my treatment will be chemo or nothing (since I'm also HER2- and there's no reason to consider radiation since I had a very clean BMX) which effectively means I have same choices as those of triple negs.

He thinks the Oncotype DX could help me to decide, so we're checking in to that. I guess "barely positive" is enough for the Oncotype DX to work; I'm happy about this!

Oncotype DX and other tests...

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