Oncotype DX Score 67

Izzy,  you sound like you have a great attitude towards treatment and I echo what voraciousreader says - get a second opinion if you are not pleased with your oncologist's attitude.  I want to hear everything my oncologist has to say about cancer, treatment, side effects, etc...but I pay for his services and I deeply resent him venturing into any conversation in which he judges me...and I told him so!  He is my doctor, not my therapist, and I don't care about his opinion of my attitude.  I'm a grownup and my attitude belongs to me.

That having been said, I agree with voraciousreader about the Oconotype scoring.  Before my surgery, my doctor could feel my tumor and knew that it was at least 1.5 centimeters.  He was very clear that chemotherapy is recommended for ANY tumor over 1 centimeter, regardless of its pathology (and many, but not all, oncologists agree).  With the size of your tumor, I would have thought that chemo would also be a given.  Also, the HER status should have been determined before it was submitted for Oconotype, because its HER status takes precedence over its Oconotype score.  Even ladies with smaller HER positive tumors are being recommended for chemo and Herceptin as it dramatically reduces their chance of recurrence (which is significantly higher for HER positive tumors, regardless of size).  It does not make sense to me, given your tumor's size and HER status, why your doctor ordered such an expensive test (Oconotype).  It wasn't going to give you any additional information that would have impacted your treatment.  

My doctor entered my pathology information on AdjuvantOnline and told me that my chances for recurrence without chemo/herceptin were about 40% and with treatment were about 17% (1.7 centimeter tumor, 2 of 25 nodes positive).  My guess is that most all HER positive breast cancer falls at least around this much.  Fortunately, chemo is particularly effective on aggressive cancer and herceptin is a godsend.  When you are finished with Herceptin, there are other exciting clinical trials available for HER positive breast cancer - vaccine trials and Neraptinib.  

There is no good cancer...but much is being done with the type of cancer that we have and while it is all serious, choosing to have a positive, can-do attitude that keeps you faithful to your treatment and your health is the first requirement - you seem to have that in spades!!!!  Kelly 

I agree with the others - the reason other Her2+ don't post oncotype score, is because the test is almost never performed on Her2+ tumors (and not indicated for Her2+ tumors) since it is virtually a given that the result will be high.  Therefore chemo + herceptin is automatic for all but the most tiny tumors.

I work for a company that has a partnership with this company and they have said many times that all grade 3 Her2 tumors come out with very high oncotype, I had mine done as well (really didn't need to as it did not change my treatment) but has a very high score 48.

Even though you have a very high oncotype you actually have less chance of recurrence then your none Her2 counterparts (grade 3)  as with Herceptin an early stage Her2 DX like yours has less then a 15 percent chance of recurrence after a year of Herceptin.