GRADE 3 and Oncotype

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bluepearl
bluepearl Member Posts: 961
edited June 2014 in Stage I Breast Cancer

Did anyone have a grade 3 tumor but a low oncotype????

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited September 2013

    I have a grade 2 and an oncotypedx of 3. I considered getting a second opinion RE: final path staging from Johns Hopkins (check it out online - it is like $250) but I chickened out. My genetic md has done extensive BC research and said that NO DOUBT oncotype trumps grade. He said grade is somewhat old fashioned and subjective to the pathologist.

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  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited September 2013

    I was grade 3, oncotype 19, bottom of the "grey area".

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  • bluepearl
    bluepearl Member Posts: 961
    edited September 2013

    Thank you. I had THREE tests done on my specimen.....two said grade 3, one said grade 2, two said no LVI, one said there was but because the two grade 3/no LVI were done by the Canadian Cancer clinic, I went with them rather than the hospital. I am remembering my score was 6 per 10 field magnification or something, and I think that was a "low" end grade 3 or a high end grade 2...do wish I had taken t he onco test but three times they didn't recommend it. BayouBabe: what did the doc say about the LVI and chemo? I read that there are three varieties of LVI...focal, intermediate and extensive and only the latter affected prognosis negatively...so am thinking that's probably what your LVI was...focal. I had heard too that grade was "old fashioned" as well. What bumped me up to grade 3 was the mitotic rate (from 1 to 2) . Bleh. I guess I won't worry too much and run with only the good news. Best wishes and thank you for responding...gives cause for hope.

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  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited September 2013

    My LVI was focal. MO said Oncotype trumped LVI and grade. Also, I was highly ER+, so MO felt an AI was my best bet in moving ahead. Always go with the good news! Us BC girls have already had too much bad news! Always have hope - some days it is all that keeps us going. Hugs!

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  • bluepearl
    bluepearl Member Posts: 961
    edited September 2013

    Yes...my ER was highly + as well. EVEN if I were still LVI + it would have had to have been too small for two other negative findings. I can twist the facts around like crazy! I'll be on anti hormonals for 10 years...do you have that protocol as well. It may be because I've had two primaries. I always wonder if one had a high oncotype score but a very small tumor if the treatment options are less aggressive and/or an option only. I've seen BIG tumors with low onco lead to mets on these discussion boards.....and small ones with high, no mets. I guess in can be at times a crap shoot....heavy on the crap part. :))))))

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  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited September 2013

    Definitely heavy on the crap part! :) My MO will not answer me when I ask about time on an AI, says time and new studies will determine things for me in the future. I tell myself I am only doing this for five years. It will be a struggle to make it that long. Side effects are killer for me. I need to look forward to a better quality of life at the end of five years, or I have no motivation to keep swallowing these pills every day.

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  • gingerale
    gingerale Member Posts: 2
    edited September 2013

    I had a grade 3 tumor and an oncotype score of 17.  Almost 4 years ago.  Have been on exemestane about 3 and a half years.  The side effects were rough at first but not as much now.  Or maybe I just got used to achy and stiff joints, trouble sleeping, etc., etc.  Tumor marker tests every six months are normal, mammograms normal.  Oncologist said the more time passes the better as far as a recurrence goes.  Good luck to you!!

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  • bevin
    bevin Member Posts: 1,902
    edited September 2013

    Hi, I had grade 3 as well and an oncotype of 11.  I was offered chemo as my tumor was over 2cm, and I'm young, but to me, based on no lymph node and no LVI, it seemed best to forgo.  I don't know why I had a lower score. My MO also said different areas of the tumor express differnently so that could explain the gap too.

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  • WaveWhisperer
    WaveWhisperer Member Posts: 898
    edited November 2013


    I had grade 3 and surprisingly, an Oncotype score of 9!! I still opted for chemo, given that I had micromets in one node. All that was 2 years ago. I was on Arimidex and suffered such severe joint stiffness that my MO switched me to Aromasin in July, and it's been much kinder to my bones.

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  • momof2doxies
    momof2doxies Member Posts: 342
    edited November 2013


    I had grade 3 and an oncotype 19 last year. with no chemo, only rads and arimidex. Now one year later, I have another primary tumor that is borderline being triple negative, still grade 3. I will know on 10/20 whether I will receive chemo due to another oncotype. My bets are on chemo this time? Anyone want to bet against me? LOL

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited November 2013

    So sorry for the new primary momof2doxies. Wishing you a very low onco score.

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  • momof2doxies
    momof2doxies Member Posts: 342
    edited November 2013


    Grade 3, Triple negative, second primary tumor....Drum roll....Oncotype Dx = 42


    The triple negative was an added bonus supplied by Genomic Health...need to buy stock in that dang company...now to go have my pity party in bed

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited November 2013

    Oh momof2doxies - I am so sorry. I wish I could give a big hug. Hang in there. Sad

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  • beckstar18
    beckstar18 Member Posts: 253
    edited November 2013


    My MO didn't do an oncotype since she knew we'd be doing chemo anyway.

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  • Martessa2553
    Martessa2553 Member Posts: 33
    edited December 2013


    I had Oncotype DX test and came back at 5 percent in a period of 5 years Stage 1 grade 1. MO said no chemo but had to start on anastrozole 2mg

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  • keets858
    keets858 Member Posts: 25
    edited December 2013


    I'll get my Oncotype results on12/5; already scheduled chemo for 12/12, regardless of score. MO said due to my age (35), high grade, and small multifocal LVI he would still push chemo even with a low score. I agreed completely! I'll report my score as soon as I get it :)

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  • joanmj58
    joanmj58 Member Posts: 68
    edited December 2013


    I get my Oncotype DX back today. BS says she thinks it's going to be a high number. I replied even though I am stage 2A. Grade 3. A very aggressive tumor that has been removed. More later!

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  • joanmj58
    joanmj58 Member Posts: 68
    edited December 2013


    Just got my Oncotype score back. Score of 32. What does this mean?


    Joan

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  • keets858
    keets858 Member Posts: 25
    edited December 2013


    No low score for me - I'm also a Grade 3, Oncotype 32. I was hoping for a lower number, oh well!


    Joan, MO says I have a 21% chance of distant recurrence without chemo; with chemo I can lower the percentage.

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  • jessica749
    jessica749 Member Posts: 429
    edited December 2013


    Hmmm…if this were a scientific survey it would seem that being grade 3 means a dicey oncotype…so then, what is the point of oncotype? supposedly trumps grade but if grade accurately predicts…???!!!! As it seems to…


    (Of course the big diff. here is that the above 'survey' is not scientific!)


    Yes, a self serving post by someone with a grade 3 who didn't have oncotype but did get chemo. That would be me.

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  • NancyHB
    NancyHB Member Posts: 1,512
    edited December 2013


    Jessica, what you say sounds right (in theory...) Yet I had a Grade 2, Stage 1, with an Oncotype score of 42. I still love to tell the story of when my MO called me to tell me, and said, "I've never seen a score this high!" I totally surprised everyone. I'm techinically ER+, but the Oncotype test changed me to virtually TN. I find the range of available tests - and test results - so different and interesting...

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  • CruiserMay
    CruiserMay Member Posts: 11
    edited January 2014

    grade 3 and an oncotype of ... 29! I had already decided that I would do chemo just in case any rebel cells decided to hitch a ride elsewhere in my body. I had chemo August thru Dec. and just had my first of 33 radiation treatments today. It's not been a great few months, but I'm trying to take control of my life! Best to all of you on your journey.

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  • LizzieK
    LizzieK Member Posts: 67
    edited January 2014

    Grade 2 ER+ Just got my Oncotype score at 17, so no chemo for me.  The report also has me at the top of the scale for ER+ (11.5 out of 12.5) so I guess pills are in my future.  I read somewhere that breast tumors in the same person often don't have the same profiles when it comes to ER, PR, HERS, etc.  So you can have a tumor with one profile today and if it recurs it could be a whole different profile.  I don't think they know why.

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  • LindseyLadd
    LindseyLadd Member Posts: 10
    edited January 2014

    I just heard that my oncotype is 17.  According to my surgeon, this translates to 11% recurrance rate if I do at least 5 years of tamoxifen and could decrease to 6-8% with chemo as well.  She felt on the fence about chemo and basically said that its up to me, but that there may be added benefit, since I'm young, only 28.  I have an appointment with my oncologist today, so I guess I'll have to wait and see what she says.  I'd love to avoid chemo, but I suppose I'll do it if I need to.  Anyone out there hear a stronger case for chemo if you're pre-menopause?

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited January 2014

    Lindsey - I would definitely get several opinions. Also you might try the ladies in the Young with Breast Cancer thread near the bottom of the list.

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  • QuinnCat
    QuinnCat Member Posts: 3,456
    edited January 2014

    Lindsey, the whole idea of the oncotype score is to figure out who needs chemo and who doesn't.   In the past, before oncotyping, grade 3's always got chemo, nodes or not.  Having said that, and this is my personal opinion, I would want extra confirmation of that low score given you are grade 3.   Whether that is finding out how many samples were tested to even asking that your sample be retested, or maybe even getting the mammoprint test to corroborate.   It's not that it cannot happen - (grade 3 with your score) - that is the point of the oncotype, afterall, but given your age, especially, I would want to be especially sure about that mismatch.

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