Oncotype Dx Test Anyone?

Hi all,  

Thought I would share this url that will take you to a supplemental table/spreadsheet that will let you estimate your oncotype score with three different regression analyses.  The ER and PR numbers range from 0-300...so if you are 100% ER positive, enter 300....if you are 50%, enter 150, etc.  If you want to read the entire article, chop off the url starting /suppinfo.   I used this while I was waiting for my oncotype and it was really close when I averaged all three.   MsP

http://www.nature.com/modpathol/journal/vaop/ncurrent/suppinfo/modpathol201336s1.html

The green sections are where you enter the variables for each of the categories and the highlighted yellow area is where the computed recurrence score is reflected.  If you are not familiar with Excel spreadsheets, ask someone who is to help you.

Hi, Warrior....

You did it perfectly!  One thing I did was to do a high/low for each model because even though my pathology said 100% ER, I knew that wasn't the case....so I did it once with 300 and the second time with 270 and I did that for any of the categories that I wasn't sure about.  For instance my nottinham score was a 4 on the biopsy and a 5 on the surgical pathology.    Then I ended up with 6 scores, a high and low for each model.  When I was done, the average score was 21 which was pretty close to the 24 I got on the Onco.  At least I was prepared for being in the dreaded gray zone!!  All that said, I did opt for chemo.  I did pretty good and am glad I did it.

Good luck to you, hon.

Warrior, of the 6 scores I created,  the highest was 23.   Something that helped me during the wait was to use that time to decide (with my family) where my cut off was.  And I did a lot of research about chemo and side effects, etc.  Thats when I learned that it is possible to maintain a normal schedule during chemo.  So while I was disappointed when I got my score, I was ready to go, physically and emotionally.  

I know the waiting is hard.

MsP

Warrior woman, good morning.  Yes I get up early every day.  Love it!  So my score was in the middle of the middle and im not so sure that if it was a 23 , i would have opted out of chemo just because it was at the lower end of the middle.    For me it was the degree of distant recurrence risk reduction I was getting.  The oncotype score includes a recurrence score.  At 24, my recurrence score was 16.  Chemo gives you a 20 percent risk improvement as follows:  16X.20..3.2 point reduction.  So my 16 becomes 12.8.   You can see that a lower oncotype, let's say 21 , might have a recurrence score of 14...so chemo might reduce that to 11.2.  For me, I estimated 20 or above to be chemo for sure and that I would go with my oncs recommendation if it was lower than 20.

But, you should take other things into consideration, in my opinion.  How old are you?  If you are under 50, you've got a lot of years of living ahead so your risk horizon is longer and if you have children who depend on you, that may make you more risk averse.  How healthy are you?  I am a hardy, active person and knew I could handle chemo.  (i was right.  LOL).  The way I looked at it was that my real distant recurrence risk was either 0 or 100 percent and there is no cure for breast cancer....you only know if you are cured if you die of something else so....chemo for me was my chance for a cure as a stage 1 patient. 

I hope this gives you food for thought.  These decisions are not easy but once you make them, everything falls into place. 

Love, MsP

Hi  Live your name. I am one year out of the Onco test and I get it....the entire process from start to finish is like being in a bad dream...Just live it out...that is my advice. Waiting for that test was nearly as bad as hearing the initial news...Keep busy, enjoy the holidays w your family and keep positive. Mine was fairly good news and so we all live with this and it will get easier....you will adjust and take your life back. We are with you. What is, is...accept and do what you have to do...you will be a stronger person through it and you will receive many gifts...be open to receive them. I send you strength and peace....

Warrior

I concur with Pharoah--it is good to figure out what your "line in the sand will be" and you do have to consider things like your age, health, etc.  I ended up in the gray area-- I had 2 kids, 12 and 7 and I was hale and hardy---so I did 4 A/C treatments-- I am a higher education professional and was able to be at work most of the time--- my chemo was done over an 8 week period, so honestly, it went by fairly quickly-- it was the dead of winter, so it was not like I was missing out on much--- 

I hope you get a low score and don't have to make any decisions.  But if things turn out differently, know that it can be done--- when I look back now, I am amazed at what I did..... I was pretty awesome!!!!!    

I am just about 5 years out from treatment--still pretty hale and hardy--- my kids are now 12 and 17 and  I don't think they remember much about it-- we kept their lives pretty normal during that time..... 

I wouldn't want to do it again, but I know if I had to, I could.  You are stronger than you think... but let's just hope for a 0 on the oncotpye

I so feel your pain.  My insurance authorization for the test got misfiled by the insurance company three weeks ago.  I went to my oncologist last Fri. for the Oncotype Dx results.  My oncologist said we could go ahead with radiation because she does not expect my Oncotype results to be anything but low risk.  I said I needed to wait until the test comes back which adds another two weeks (probably more with the holidays).  It is so frustrating.  I would like to get on with whatever treatment so I could get my life back sooner rather than later.  It seems all I do is wait, wait, wait.

No result is easy to wait for.  Sending good thoughts.

My first onco (fired him) said he was positive I would be low.  i ended up at 20.  4% benefit if I followed up with tamoxifen and 3 doctors said not worth doing the chemo.  Maybe because mine was ILC? or maybe the risk of chemo is not worth a 4% benefit.  I never gave myself a cut-off.  I looked at mitosis/grade/type of cancer and risk/benefit ratio of chemo.  

Best to you.

I think the study mentioned above might be the TailorX study.

I have always felt grateful that my score was 42 - not because I'm an over-achiever (which I am), but because it left no doubt in my mind that I needed chemo, and that chemo would be a benefit to me.  I did try - twice - Tamoxifen, and gave it up, so my recurrence score is a little higher now than it would be had I followed protocol.  And I did my 20 weeks of chemo over winter/spring of my first year of grad school, and worked as a grad assistant, and while it was tough it wasn't impossible (frankly, I enjoyed being part of the academic world and have really hated to leave it behind - almost makes going back to get a doctorate an enjoyable idea!)  

Pharoah, thanks for the link.  I played with it using the results I have to determine my ki67 (my pathologist's lab does not do the ki-67 so it's the one piece of the puzzle I didn't have, and wondered about).  Interestingly enough, given what I *do* know (including my final Oncotype score) - my ki67 is somewhere around 96.  Cripes.

Good luck, Warrior Woman - I hope your results are cut-and-dried one way or another.

WW

the year I was diagnosed, the markets tanked, every xmas party was cancelled--I did not have to be social--it was like the universe was helping me during the waiting and diagnosis--and frankly, doing chemo in January and February was great-- no one was out, (I live in the NE) so I could just fly under the radar at work and at home.

did you see the onc yesterday???