Oncotype DX test "failure"

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jessica749
jessica749 Member Posts: 429
edited June 2014 in Stage I Breast Cancer

Okay, waiting on pins and needles for oncotype test results. Called hospital today and learned that the test "failed", meaning that there was not enough sample from my 6 mm cancer to conduct the test. Apparently, a solid small percentage of the samples 5 mm and under "fail" (are inconclusive I suppose, or cannot get a result)..apparently at 6 mm mine was one of them.  I was very surprised at this news. I was so worried about various results. I never considered no result!  It's like the clock of time is turning back on me, hello 2001! Make your treatment decisions accordingly.  Am I alone on the oncotype test failure? Anyone ever hear of this? I wonder if my insurance is still going to be charged 4k....

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  • TinaT
    TinaT Member Posts: 2,300
    edited March 2011
    KSD:  How disheartening!  I'm just learning about the Oncotype DX.  My main cancer was fairly small as well so I hope I don't end up in the same boat.  I would think there might be some charges for processing the request and getting the sample?  Sorry, I've never heard this.  I can understand how upset you must be! 
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  • Rennasus
    Rennasus Member Posts: 1,267
    edited March 2011

    KSD...

    I have never heard of Oncotype test failure! So sorry you got that result. What a complete letdown to wait all this time and then get a big nothing for an answer!

    While you have been waiting for the oncotype results, did your Oncologist give you any indication of what treatment plan he/she has in mind for you? (Mine knew what he was going to do before I got my results; the results just confirmed it for him.)

    The good news is that your tumor was caught early. Did you have a lumpectomy? 

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  • TinaT
    TinaT Member Posts: 2,300
    edited March 2011

    Did your oncologist discuss the Adjuvent! Online profile?  It makes predictions as well, but it's not a genomic test.  It does not test your actual tissue, but it compares your pathology to a large database using info such as your basic health, tumor size, lymph node results, etc.  I'm not sure if your pathology works with that program, but it might be worth asking about.

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  • Rennasus
    Rennasus Member Posts: 1,267
    edited March 2011

    KSD: I agree with Tine, the Adjuvent Online is a great alternate tool! I think your doc has to access it tho, so be sure to ask him/her about it.

    (TinaT: I couldn't help but notice we were diagnosed on same day, are same Stage and Grade and both had BMX. Only difference is you have ILC, I have IDC (and my mass was 3x bigger). What is your treatment plan?)

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  • jessica749
    jessica749 Member Posts: 429
    edited March 2011

    Yeah, onc said I'm getting Tamoxifen but that the chemo Q would be answered by the Oncotype. Oh well. In the absence thereof, I may feel most comfortable doing it. Assume the worst, hope for the best. That's my modus operandi.  I don't think going forward I will regret "having done" it, but I do think that I would regret it if I didn't.  So that answers the Q for me. I think my onc hoped to avoid unnecessary treatement with a great oncotype score. Oh well.

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  • cookiegal
    cookiegal Member Posts: 3,296
    edited March 2011

    Can you get a KI67 reading? I think that plus the level of ER would give you a basis to see how responsive your cancer would be.

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  • TinaT
    TinaT Member Posts: 2,300
    edited March 2011

    Rennasus:  I had nipple sparing surgery and TE placement Feb. 16.  Currently dealing with some tissue necrosis Cry before proceeding with expansions.  Cancers very small, non-agressive and no positive lymph nodes so my oncologist felt comfortable recommending Tamoxifen or Arimidex and no chemo per the Adjuvent! Online database.  I requested the Oncotype DX to ease my mind and that is currently underway (request fell through the cracks somewhere so instead of the process being started 2 weeks ago the lab just got the request today).  Have chosen to start with Arimidex and hopefully the NO CHEMO will be confirmed via Oncotype DX.

    Have you started Tamoxifen yet? 

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited March 2011

    What about the Mammaprint genetic test?  Is there still enough of a sample from your biopsy for THAT test?  I'm not familiar with the protocol for the Mammaprint.  Perhaps you can find out.

    I'm really sorry about what happened.  I know how frustrating it must have been to have this happen during your decision making process.  In any case, I wish you well. 

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  • edwards750
    edwards750 Member Posts: 3,761
    edited March 2011

    KSD - So sorry about the test; have to admit I have never heard of a test failure. I had the test a few weeks ago. My onc was ambivalent about whether I would have the chemo regimen or rads so she requested the test be done. Thank goodness because my score came back low - 11 so I am having rads in a month.  There has to be an alternate test they can do. I would ask my oncologist. Good luck and keep us posted.

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  • jessica749
    jessica749 Member Posts: 429
    edited March 2011

    Follow up Note: Spoke to the company today, they told me that a minimum of 2 mm invasive cancer is needed to conduct the test. Sometimes they receive a sample that has already been tested for E, PR, HER2 etc and there turns out not to be enough, ie failure. In which case, if there is more available from the hospital,  they'll request another sample.  PS If they are unable to complete the test, i.e. failure, there is no charge for it. 

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited March 2011

    Thanks for the update!  Good luck to you. 

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  • Rennasus
    Rennasus Member Posts: 1,267
    edited March 2011

    KSD, that is so great that you called the company and got the actual explanation. Hopefully your hospital can send them another sample. And also great news that there is no charge if they can't repeat the test! Please keep us posted.

    TinaT, I just sent you a PM.

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  • Rennasus
    Rennasus Member Posts: 1,267
    edited March 2011

    KSD, here is another online tool if this helps at all: http://cancer.lifemath.net/

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  • renmars21
    renmars21 Member Posts: 55
    edited August 2011

    KSD- I too had an incomplete test as my sample was only 1.1mm.  Final pathology indicated that I had .08mm Tumor Cell in 1 sentinal node so as a precuation my Oncologist tried to get an Oncotype ccore. He is not recommending Chemo for me.  I'm relieved by scared.

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  • rockwell_girl
    rockwell_girl Member Posts: 1,710
    edited March 2011

    My invasive cancer was 1.1 cm, the 1st time they tried doing the test the sample they sent wasn't big enough but it worked the 2nd time and I came in with a 16 whooo hoooo : )

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  • annie06
    annie06 Member Posts: 156
    edited May 2011

    I know this was a while ago....but mine failed too. Still waiting for results...interesting, huh? Mine was 1.7 cm IDC. Crazy??? Hoping to have results in less than a week. And this is my second dx.

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  • eulabt
    eulabt Member Posts: 194
    edited May 2011

    This happened to me as well. I was so mad at my Onc. I found out that they couldn't get a result from my 2nd opinion Onc, not even the Onco that ordered the test.

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  • Maybe484
    Maybe484 Member Posts: 170
    edited June 2011

    This happened to me just today.  I had an appointment with my second opinion surgeon who performed my re-excision.  I was diagnosed with BC on 4/12 and STILL don't know my recommended course of treatment beyond surgery.  The second surgeon sent in my re-excision tissue, and, while it contained residual cancer (with clean margins), there was not enough to run the Oncotype Dx.  So now I have to wait 2 more weeks while she obtains my original excision tissue from another hospital.  I hope there's enough to run the Oncotype Dx.

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  • Chocolaterocks
    Chocolaterocks Member Posts: 364
    edited June 2011

    MAYBE 484  - my onco said there was not enough to run the onco and I said try it anyway and they did -3.8mm and they did run it- onco score of 1 anyway if they can't they will send it back

    Good luck!

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  • Maybe484
    Maybe484 Member Posts: 170
    edited June 2011

    Thank you.  The Oncotype Dx company called my surgeon yesterday to say there wasn't enough cancer to test in the re-excision tissue.  So hopefully there's enough remaining (after all of the other tests) on the original excision tissue.  I'm antsy to get this show on the road!   

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  • Chocolaterocks
    Chocolaterocks Member Posts: 364
    edited June 2011

    Sorry Maybe484- well atleast you know its small- good luck!

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  • mommarch
    mommarch Member Posts: 584
    edited June 2011

    They also said there was not enough tissue to do my Oncotype test.  They sent out to another pathology lab for my biopsy sample, as the surgeon who did my lumpectomy said that my Dr. who did the biopsy had got most of the tumor, it was 2.7 cm.  Hoping they can get a reading on the biopsy sample.  Tierd of being in limbo.

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  • Atw1218
    Atw1218 Member Posts: 11
    edited July 2011

    I found out on Friday that my oncotype dx test "failed". I didn't even know this was a possibility and after my docs touting it as being such a strong diagnostic tool I just want to scream that it isn't available. They are sending my biopsy sAmple but I have no idea how big that is. Has anyone else had their dx done on the biopsy? Is there any hope this will work? I was diagnosed in April. 34 years old, 1.8 cm tumor, grade 2, no node involvement. I had a bilateral mastectomy with clean margins but now have NO idea on chemo! Thanks so much for this forum. The info and "you are not alone" has been very helpful.

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  • mommarch
    mommarch Member Posts: 584
    edited July 2011

    I had the same think happen.  When they did the biopsy they took most of the lump so the sample sent in by the BS was not large enough.  They sent in the biopsy tissue and we got a reading, Unfortunatly my score was 37 so I am taking chemo  AC , every 3 weeks for 6 months.  First one was on June 14th, did OK, second is July 14th.  Hope this is of some consulation

    Hugs

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  • Atw1218
    Atw1218 Member Posts: 11
    edited July 2011

    Thank you for the quick response. It will help me sleep a bit with hope that they may be able to tell something from the biopsy! I was just really hoping for more info and not getting a dx score was very disheartening. I wish you very much luck with the chemo!

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  • TinaT
    TinaT Member Posts: 2,300
    edited July 2011
    Atw1218:  I was also concerned when paperwork slipped through the cracks and the whole time I thought I was waiting for results nothing was actually happening!  I was worried that it would be too late, but I was told that the tumor tissues are saved in wax blocks and are stored and useable for years.  So, your biopsy tissue from April should be fine.  Hang in there!!!
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  • Atw1218
    Atw1218 Member Posts: 11
    edited July 2011

    Thanks Tina! I was worried about time and how on Earth can the biopsy sample be an ok size if the tumor section wasn't?! but it sounds like results from a biopsy may be feasible. Whew. Back to finger crossing. Thanks again for making me feel a bit more calm! I really appreciate the sounding board.

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  • TinaT
    TinaT Member Posts: 2,300
    edited July 2011

    Atw1218: I don't know what kind of biopsy you had, but a core or vacuum-assisted biopsy can apparently be a fairly good-sized sample.  In the case of one of my cancers, DCIS was the report at biopsy, but only ADH was found in the area of the clip at surgery.  So, most of that tumor was removed with the biopsy!

    Hang tight!!!

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  • Genni
    Genni Member Posts: 1
    edited July 2011

     I too had a ONCO DX test failure TWICE.  I'm stage 1, DCIS, Clear margins, grade 3, tumor size 0.8.  Diagnosis March 10, 2011, Surgery May 3, 2011.  Will start Rad or Chemo next week.  So I must decide over the weekend which route to go.  The doctor left it up to me but he does recommend 4 Chemo treaments.

    Lost mom to colon cancer a couple of years ago.  I'm very hopeful

    Genni

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  • Atw1218
    Atw1218 Member Posts: 11
    edited July 2011

    Genni - if you don't mind sharing I'd love to know what you decide re: chemo. I am definitely doing tamoxifen which will give me the best "bang for my buck". But my dr has also recommended chemo although he did allow that it was not mandatory and the benefit from chemo is less than the benefit from tamoxifen in my case. So I am wrestling with the chemo question also!

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