Oncotype test for DCIS post-surgery radiation decisions

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  • ZTeam
    ZTeam Member Posts: 44
    edited December 2011

    No kidding. I asked my RO what she would do if she were in my position and she said she couldn't answer that. Thanks a lot!

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  • Hindsfeet
    Hindsfeet Member Posts: 2,456
    edited December 2011

    This is fantastic news. I had no oncotype test for my first two dcis dx. I lumped all dcis into the same catergory risk assessment. We were all stage 0 and treated the same. I've always felt that  dcis might be overtreated. In my case the oncotype test score would had been higher in that I proved in 4 years to be dx 4 times and my high grade come-nec type did become invasive with the her2+. I was told after first dx that surgery alone with rads gave me 5% advantage and most likely with clear margins the odds were I would not have a recurrence. I didn't believe at that time 5% was significant enough to warrant rads or losing my breast so I took the watch and wait approach.

    Beesie corrected me after second dx of multifocal on what the ro said in regard to the 5% risk. If I knew my risk were higher for recurrence, I might had gotten a blmx last Spring. I was playing with the odds it wouldn't in the realm of recurrence factor being unknown even for grade 3 como type of dcis. The oncotype test might had made me consider removing my breast sooner to eliminate possible invasive cancer or the idc cancer I now have...My first dcis, and possible second local recurrance came back as idc in 2 yrs.

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  • dancetrancer
    dancetrancer Member Posts: 4,039
    edited December 2011

    LOL Zteam.  And yes evebarry, this is indeed fantastic news and will help many women make oh so difficult decisions.  

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  • Natters
    Natters Member Posts: 361
    edited December 2011

    Or their daughters' bodies?

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  • dancetrancer
    dancetrancer Member Posts: 4,039
    edited December 2011

    So true Natters.  I hope at least women who have lumpectomies will be able to get this test from their docs! 

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  • cycle-path
    cycle-path Member Posts: 1,502
    edited December 2011

    If I recall correctly (never a good bet at my age), Beesie has said that some DCIS will never turn into IDC, and other DCIS *will,* but the problem is that the docs have no way of knowing which is which.

    I'm thinking that this test could be the first step toward knowing which is which. 

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  • miricurt538
    miricurt538 Member Posts: 73
    edited December 2011

    this seems notable to me also.  I was dx last month with DCIS after lumpectomy.  I met with the oncologist yesterday for the first time and since I had seen this newscast, I wanted to hear her opinion on it.  When I mentioned the Oncotype dx test she undoubtedly hadn't heard of this last one out of San Antonio because she said that was testing for who needed chemo and you were never considered for that.  Since my brain hasn't been too dependable these last couple of months, I accepted that she was right.  When I got home it suddenly hit me----I knew I was remembering correctly---it was for women with DCIS and it was for radiation.  I talked to my Transporter about it today.  She Googled it becaause she hadn't heard about it either and after reading it she said I should call the dr and tell her about it.  I guess it is coming to late for me though, since I've had to wait so long between everything that it is about time to start radiation and I don't want to wait too long on something that isn't a sure thing.  Is there always not a straight answer to anything in connection with breast cancer?

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  • dancetrancer
    dancetrancer Member Posts: 4,039
    edited December 2011

    Exactly cycle-path - it's quite exciting and offers great promise.

    Miricurt - I feel your pain!  No easy answers on the crappy cancer journey.   

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  • miricurt538
    miricurt538 Member Posts: 73
    edited December 2011

    A little progress since last posting Dec. 9.  I talked to radiation oncologist about Oncotype DX.  He hadn't really studied the latest study on it but had read  about it.  When I told him what I understood about it he said he was willing for me to see about doing it.  He called the Med. oncologist's office for her to order it.  Then the Med. onc. nurse called me and said she had sent the order to the pathologist for them to get off the biopsy tissue.  They wont be doing any testing until Dec. 28.  Hope I can get an answer in time.I just don't want to do radiation if I should fall into that large percentage that doesn't need it.  s anyone else waiting on this testing?

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  • redsox
    redsox Member Posts: 523
    edited December 2011

    Here is a link to a press release with the complete abstract of the presentation at the San Antonio Breast Cancer Symposium: 

    http://www.sabcs.org/PressReleases/Documents/Solin.pdf

    I don't think I have seen this reference here before and this press release is more complete than many of the others.

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  • miricurt538
    miricurt538 Member Posts: 73
    edited January 2012

    BGail84       Thank you very much,Bgail, for your information on financing the Oncotype DX assay.  The med onc nurse called me yesterday to tell me she had talked to them and they talked like the doctor would have it soon.  More waiting, but I brought this one on myself.lol.  I will have to see about what my insurance is going to pay and then follow up if needed.  Thanks again..mirijoyce

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  • miricurt538
    miricurt538 Member Posts: 73
    edited January 2012

    BGail84       Thank you very much,Bgail, for your information on financing the Oncotype DX assay.  The med onc nurse called me yesterday to tell me she had talked to them and they talked like the doctor would have it soon.  More waiting, but I brought this one on myself.lol.  I will have to see about what my insurance is going to pay and then follow up if needed.  Thanks again..mirijoyce

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  • miricurt538
    miricurt538 Member Posts: 73
    edited January 2012

    Bgail84,  Thanks so much for your information on financing the Oncotype DX assay.  I am waiting for mine to come in to the med. Onc.so she can  figure out the conclusion and see if I have to get rads.  I am going to have to put my faith into this whichever way it goes.Hope ins. pays on this.  I know Medicare pays for the other one that shows if you have to have  chemo.      II see you are from Brandon, Ms,.  I am from Pontotoc, afew miles from Tupelo.                                                                                                                                

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  • miricurt538
    miricurt538 Member Posts: 73
    edited January 2012

    Bgail84,  Thanks so much for your information on financing the Oncotype DX assay.  I am waiting for mine to come in to the med. Onc.so she can  figure out the conclusion and see if I have to get rads.  I am going to have to put my faith into this whichever way it goes.Hope ins. pays on this.  I know Medicare pays for the other one that shows if you have to have  chemo.      II see you are from Brandon, Ms,.  I am from Pontotoc, afew miles from Tupelo.                                                                                                                                

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  • redsox
    redsox Member Posts: 523
    edited April 2012

    Bumping for Neeners.

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  • Neeners815
    Neeners815 Member Posts: 358
    edited April 2012

    Thanks very much, redsox (and that's hard to say as a Yankee fan ;)).  I guess I'll wait to see what my score is!

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  • LAstar
    LAstar Member Posts: 1,574
    edited April 2012

    My BS had not heard of the Oncotype test for DCIS, but he doubted that any test for a 42-year old woman with high-grade DCIS would indicate no need for radiation.  I looked at the Solin abstract on this test  (http://www.sabcs.org/PressReleases/Documents/Solin.pdf), and the figures in the last table are most telling to me.  Regardless of the DCIS score, the risk of any recurrence is at least 12% (and as high as 27%) without RT.  I don't want this to come back in any form, so I will probably have to accept that radiation is going to be the route I choose.  However, the Oncotype test might be helpful in determining a more personal recurrence risk not based on pathological factors when deciding whether or not to use Tamoxifen.  

    Thanks for sharing this info!  My BS always laughs at how much I have researched all of this (yes, a little scary), but I would totally be in the dark without this discussion group.  :)

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  • redsox
    redsox Member Posts: 523
    edited April 2012

    The Oncotype DX test for DCIS results presented at the San Antonio Breast Cancer Symposium came from the first study showing that this measure of the tumor biology clearly provides additional information predicting the risk of recurrence beyond clinical and pathological factors. 

    The eligibility requirements for this study were intended to allow only DCIS patients with disease thought to be favorable and low risk.  Many of us would not have been eligible.  If your doctor does not recommend the test, it may be because you would not have been eligible.

    In the analysis of the group included in the study the variables of tumor size (larger is worse) and menopausal status (pre- is worse than post-) were still significant along with the DCIS Score. 

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  • DCISdiva1
    DCISdiva1 Member Posts: 3
    edited October 2012

    I just posted on this subject in Anyone with DCIS have the Oncotype test topic.  Long post.  Here, I just want to mention that the test IS getting reimbursed.  Mine was no problem.  Getting the pathology shipped out promptly may be an issue and is worth personally confirming.  And on eligibility:  just because you would have been excluded from the patients based on whom Genomic Health created its algorithm does not mean you can't get the test and score.  My lesion was way too long to be in the study but that doesn't matter at all for ordering this test, and it's still insightful.  Was for me.  WOnderful not just for assessing whether to do radiation, but also whether to do mastectomy. 

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  • redsox
    redsox Member Posts: 523
    edited October 2012

    The Oncotype test for DCIS is one of the most exciting developments in years because it is real evidence moving toward truly personalized decision-making based on biological factors.  If I were being diagnosed now, I would want to have this test because I like to have as much information as possible.  But the data is still limited and the eligibility requirements of the study that showed the benefit of this test do matter.  I would not have met the eligibility requirements for the study. 

    If a doctor said that you would need further treatment regardless of the outcome of the test, that is good advice for many patients.  I would still want the test if it was covered by insurance or did not cost too much. 

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