oncotype and BRCA
I am anxiously awaiting the results of an oncotype test. I'm BRCA1 and had a mastectomy three months ago after DCIS was found. Pathology revealed a 1.5 cm tumour there too- no nodes involved and HER -ve.; ER/PR +.
I'm wondering if anyone had a tumour that looked like it would end up with a low oncotype score but ended up higher because they were BRCA.
Thanks!
Comments
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I'm not BRCA positive, but how would you know that the oncotype score was higher because of BRCA? Is BRCA added into the oncotype equation in some way, or is oncotype just based on the pathological characteristics of the tumor? There are some types of tumors that are more common in BRCA positive women (triple negative), and that would make the recurrence risk potentially higher, but because the tumor is triple negative.
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My onco would not even try the OncoType score. Granted, my estrogen marker was a measly 1%, so I may not have received a score anyway. She said the BRCA+ test was what she determined my treatment on, along with tumor size, nodes, etc. She said my OncoType score "would be sky high". I really did not question her. I knew I was headed for chemo, BMX and hystectomy. My ki-67 was 76%. along with the grade 3, my tumor was aggressive.
I believe, in general, that most BRCA+ women have earlier onset and more aggressive tumors. I chose the most aggressive treatment options..she said I would be a fool not to do so. -
I'm BRCA 2 positive and my onco score was 70...I don't know too many people who have score that high. But I'm practically triple negative (weak ER and PR positive) and I'm told that a higher onco is normal in that case, I think. However, my doctor told me that chemo brought my onco score down to the 20's so I'm at the same risk as most breast cancer patients now.
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My oncotype came back at 15 and confirmed that the tumour was strongly ER and PR positive. So it's tamoxifen for me-
Becuase BRCA women tend to get triple negative tumours I asked my onco. if mine was not because of the gene - but just a random occurrence. However, everyone has said because of my young age (I was 51 at diagnosis!) it was probably the gene - BRCA1 .
Best of luck to all of you!!
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hello,
i just recently had a bmx with TEs on march 6th. i had my first MO appointment yesterday and although my oncotype score was a 16 (in the low range) my tumor was consider a grade 3 but stage 1 with no node involvement and er/pr+ her2-. She seems to think that the benefits of chemo will not outweigh the risks and bascially only change my rate of recurrence by less than 2% which after hrt is 6%. I am wondering if anyone else with low oncotype scores but higher grade tumor chose or didn't chose chemo and why. my MO also explained that the onctotype pretty much trumps all of the other pathology. i am braca2 and had a hi KI67 score with poorly differentiated cells but that because my score was in the low range and there were no nodes and it is hormone receptive that chemo would not be recommended. that being said she definitely said there are women who still chose it--not exactly sure what i am feeling right now but would love to hear more from others with similar situations. i am also surprised because all of the original pathology indicated more aggression but as i mentioned she seems to feel that the oncotype trumps all. anyone else have a similar situation? I will definitely be seeking a second opinion mostly to hear the same thing and put my mind at ease to help make the decisions. i live in the philly area and would love any recommendations for MOs
thanks,
jsrose -
Hi jsrose14,
My diagnosis seems to be pretty close to yours and I am also BRCA 2 positive. I am still waiting for my Oncotype result which is driving me insane! I was just wondering if you've had a second opinion yet? What was the outcome? -
Hi rebex,
Thanks for your note. I am actually going next week for a second opinion. I went last week to another mo in the Philly area and really didn't like the appt too much but she basically said the same thing. I am hoping the woman I see next week is a bit more authoritative in terms of her opinion. I am getting more comfortable with the idea of not doing chemo but still pretty scared either way.
When did they do your test? I noticed we had surgery a day a part. I got my results back pretty quickly. Maybe a week or so. Good luck. Hoping for a low score. Please let me know the outcome.
Jsrose -
Jsrose,
They didn't send the Oncotype test out until last Monday. So I am told 10-14 days until we get a result. Gives us time to hurry and freeze embryos while waiting as once the result is in I've been told they want to act fast.
I just have this strong strong gut feeling that no matter what the results come back I want to do chemo to make sure we get it all. I don't know if I can manage through all the daily what if's.
I have an appointment next friday with a high risk breast oncologist for a second opinion. I will let u know what she says and you keep posted as well please :-) -
Hi, ki situation is very similar . My RS is 16, stage 1,grade 3, ki 67 37%, 1.5 cm, N0, M0. ER and PR positive, her2negative. I have seen several physician and I dont find two with the same treatment. What happened with you? Yes or no chemo?I am afraid to do a wrong decision. It is driving me insane.
Thank you very much
I am 45 years old
I wish the best for you -
bernadf-
not sure if you were writing to me but I did decide to do chemo. it was the hardest decision i had to make in the whole process and tomorrow is my 4th treatment out of 8. chemo is not fun but i am hoping to just get thru it and move on. it's such a personal decision but i knew that when i thought about not doing it, there was too much worry for me to live with so i opted for it and my onc was fine with it. she said it was definitely reasonable.
good luck with your decision. i would go with the opinion that sits best with you. i also did not have agreement but ultimately went with my gut.
best,
jsrose -
jsrose
I greatly appreciate your answer. Probably it is not what I wanted to hear, because I am not sure to want chemo, but I have much fear about my final decision. Probably, for me it is the most dificult decision in the process .
Just one more thing, what treatment you are using?
Thank you very very very much
The best for you
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Bernadf-
I am doing a regimen of chemo called cmf. I cannot see your statistics but did you have positive nodes?
Sorry you are having such a hard time deciding. I did as well but once you make a decision it gets easier.
Good luck
Jsrose
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