Another Oncotype question

mary71, I agree that a low PR+ will likely tip the scales to a higher oncotype score.  I've understood that the degree of staining is of some importance and have wondered if it is taken into consideration on the oncotype.  My ER and PR are lower than anndh's and Ki 67 higher, yet she had an oncotype score 4 pts higher than mine.  My ER/PR were highly stained.  I've not found this issue addressed in research papers trying to find a cheap way to approximate the oncotype score, probably because it is too difficult to get the data and very subjective.  

Anyone else want to weigh in one this you your stats?   

Otter - you're the only one who's ever been able to crack the code on what gene expressions they look at to compile the Oncotype score. I'm actually not surprised I really liked your explanantion though. Much better than any I got. 

Mary71, it's always a good idea to get input from here...as you said, they know what the real deal is. My own ER was 80% PR 95% onco was 50... but I was also HER+++ and my understanding is that usually equates to a higher score. I've also had one other cancer myself, and a family history of Liver cancer, so my score wasn't a surprise to me. I was glad to have it, as they initially wanted to only do hormonal treatment since I had a bmx. I didn't necessarily WANT to do chemo, but I'd hate to have needed it and not got it.

Best wishes on settling on a treatment plan, follow your gut, sometimes it's your best guide.

Navy 

Vicki - You're Her2+ and that is probably why your oncotype is so high.....that makes sense.  I'm surprised they even ordered an oncotype?

I guess this thread is in a resting phase?  Too bad, I was hoping someone would be able to translate my oncotype of 51 into a percent?  I see many of you giving a score then corrosponding percent and I have no idea how to get that.  Have an appt with my Med Onco on Monday to discuss the still puzzling results of my path report from the mastectomy.  In most other situations, I would find it funny that I have doc's scratching their heads, but in this case, not so much. 

I had higher PR than ER. but ER was still moderate...it is actually GOOD news to have a higher PR because I read in some pubmed publications, there's a lower mets with that. But with cancer, there are NO 100% anything. Just stats and probabilities. Each one of carries our own monster as latest research says there's 40 genes involved in initating breast cancer!!!!

Bluepearl - my UCLA MO said that a high PR was a good thing to have as it indicated a less aggressive cancer. So, it seems like what we want for a low Oncotype score is ER and PR as high as possible and KI67 and grade as low as possible. My MO claims to be able to predict Oncotype scores (low, intermediate or high at least) with just these four factors. I would think HER2+ would automatically give a higher score but we didn't discuss that since I'm HER2-.

Not sure what the test is and what it shows. I was not given it for some reason---

Dogsandjogs: I don't think they automatically give the oncotype if the Mo and you agree on the treatment plan. My first MO said no chemo or Herceptin due to the small size and wouldn't order an oncotype because I am HER2+!

This didn't sit well with me so I have a new oncologist who agreed that an oncotype would be called for. I get to review it with some other test results tomorrow. Even if the treatment plan is the same....I feel more confident in getting as much info as possible. And all the ladies on this site have encouraged me to be more assertive in my care plan! Thank you ladies!

Here's a head scratcher: my ER was around 30%, my PR neg

( don't know %, will ask Weds) . However, on my oncotype it said ER neg. now, the onco is really only for ER pos, right? My dOc said he'd never seen that discrepancy before. Could be diff cutoffs but weird. The chemo was what he thought was best anyway but want to understand more about this.

Not so strange Dogs&j, I suspect that many of them don't suggest the test if they feel certain of the direction they want to go.  It's a very expensive test, in the neighborhood of $4500.  In my case the pathology of the tumor seemed to say chemo wasn't warranted, but the size of the primary tumor, and the fact that it had a couple of evil little friends meant that MO would have recommended chemo out of an abundance of caution (pre OncDx)  so after agreeing that I didn't have strong feelings one way or the other (who me?  I was so confused I wanted someone to give me THE answer) we went for the test.  Test was done in March and I believe my insurance is still denying and being appealed for payment.

I had to ask for it 3 times. MO said it wouldn't change his mind. Oh.....I thought I was the one to decide chemo or not. It came back 4, so I decided against chemo. I would have done chemo for an intermediate or high score. My MO thought I should decide just on the reoccurence pecentages from Adjuvant online he gave me. He said I needed to decide which risk to take, chemo or no chemo.

Chachamom, that is great!  Enjoy the no chemo, but you might want to check out the bottle of tamoxifan thread; lots of great info there.