Oncotype dx question

That does not sound right....2.5 cm? My Oncotype test was ordered by my oncologist. My BS was instructed to call my oncologist as soon as I got out of surgery and off the samples went to CA.

Mine was taken from my initial fine needle biopsy when I was first diagnosed because they wanted to do neoadjuvant chemo on me so that certainly was a very small specimen......

Mine was 1.5cm also and no problems with oncotype. Lucky no. 13 for me on the test, So no chemo.

Good luck to you!

Jenny

What type of BC do you have? Did you have a SNB? Are there positive nodes? I don't think they throw your samples away.

Mallory   My tests were initially rejected because of insurance.  But I don't think that your surgeon would hesitate to order the test, initially.  The surgical specimen is kept forever, from what I understand.   I have an oncotype dx pamphlet, mailed to me from Genomic Health.  It states that the test is appropriate for women who are newly diagnosed with early-stage, lymph node-negative and estrogen+ BC.  

Mallory107- From my perspective there is no problem here.  2.5 cm is way more than enough tissue.  (I was multifocal with a 2.5 cm main tumor- they only tested the main tumor).   An oncologist usually orders the oncotype dx test to determine if you need chemo.  I am guessing your BS doesn't know much about it.  The test uses a lab technique called real time PCR and it looks at the proteins (actually mRNA) that are present in your tumor.  One of the things about this test is that it requires a VERY small amounts of tissue.  The test can be done on the stored tissue from your biopsy or mastectomy - it doesn't have to be fresh.  (I asked the hospital where my tissue is stored and in their case they keep it for 10 years).   You need to be ER positive, PR positive and HER2 negative.  I think the test is now being used for women who have 1-3 positive nodes.  (See the section on "expanded use of oncotype DX" on the Genomic health web site (under information for physicians)

Some doctors just aren't on board with it. I had to ask for it 3 times before MO agreed. I had bilateral tumors 1.3 &1.6cm. My MO only agreed to the node positive side which cam back '4'.

I was told by the Genomic health rep who ran it by my insurance, that it was not a covered benefit under my plan but since Genomic health was contracted with my insurance, I wouldn't have to pay anything. They would accept what my insurance paid which they believed to be nothing. They also gave me this in writing.

My insurance paid the whole bill!! I was shocked & still confused by it all.

Mallory, just a thought/question..... Was the whole tumor IDC?  Or was it a combination of DCIS and IDC?  If you had 2.5cm of IDC that should certainly be enough to test but if your tumor included both DCIS and IDC, only the IDC portion should be tested.  And that might be too small.  

There is a new version of the Oncotype that is being used for DCIS to determine the need for radiation but I doubt that the results on the DCIS tissue would be valid for the original Oncotype test, which helps with the chemo decision on IDC. As a tumor develops from DCIS to IDC, the biology can change so as a general rule DCIS results on hormone status, grade, and other factors etc. can't be assumed to carry-over to IDC.

Your frozen sections should still be available, if you want the test.  But the test is only worthwhile if there is a question of whether or not chemo will benefit you.  Your MO may feel there is already sufficient information to make that call -if that's the case, make him/her explain why. 

Gardengumby:  How did you manage to not do chemo with even just a couple nodes positive?  My onc said even if I had one node positive she would recommend chemo - no doubt about it.  Just curious and I of course would have loved to not have to have done chemo. 

Mallory107:  Onco scores can be done on the tiniest of samples.  My sections were less than 1 cm that were tested, all before surgery, chemo, etc.  I had a score of 11 but after surgery found a pretty big tumor, and nodes, chemo was definite.