Oncotype Dx Test Anyone?

warrior woman, here is some food for thought, the people who the oncotype may not hold true for may be the ones with higher KI67. There is a study on that, I posted it somewhere a few years ago.

I actually paid the 25 bucks to read it.

I had a 22 and passed on chemo, I felt looking at the node positive chart, that there was no real chemo benefit under 21.5.

That being said another 22 (node positive) would be justified in doing it.

So for that sliver, it wasn't for me.

I could be wrong, but with the ki67 at 40, I don't think you will get a clear no chemo, but I hope I am wrong.

I honestly think in the grey if you told your onc you flipped a coin, they would be...ok

node positives have been getting oncotype since 2009 when I was treated

the only downside is the basis study is MUCH smaller, or it was

The study I referred to suggested (and again this was 2009) that the people with low oncotypes who did get mets may have been the ones with higher ki67

If your docs are saying it isn't a concern, well then, they are a lot more up to date than me

in answer to the question why, the score is another piece of information about how beneficial chemo may be, when you get the report you will see it breaks down a lot of factors

here is the best advice I have, MAKE SURE YOU ASK FOR THE REPORT

Boy can I relate to your anxiety about the "waiting period" to get the Oncotype test results. I was Stage 1, Grade 1 until after my lumpectomy the Path report showed a micromet in my SN. My BS said that would get me chemo. Not true. It is no automatic anymore. My ONC ordered the Oncotype test. Genomic Labs got approval from BCBS for insurance coverage. A few years ago when I had it done the test was around $5k. I have read it is less than that now and Genomic Labs will work with you if insurance won't cover it and you have to pay out of pocket. Anyway, my BS' office said 10-14 days before the results came back. I can tell you with absolute certainty that time period seemed like an eternity. I cant tell you how many times my BP spiked when the phone rang. Waiting for test results were more agonizing for me than the actual DX process. Anyway I got THE call the day before I was scheduled to meet with my Oncologist. I remember checking the caller id and shaking. I know chemo isn't the end of the world but lets get real no one wants to go through it. My BS needs work in the bedside manner department so I was relieved it was his nurse calling and the first thing she said was...good news and I relaxed and cried. The report was better than I hoped for and my score came back at 11. Great weight lifted to be sure. I am thankful my ONC ordered the test. She said she was ambivalent about my treatment. She also said the test afforded them more information to prevent overtreatment of patients which she admitted has been the case. So good luck with your results. Whatever they are you will get through it - we will help you. Diane

My MO concern about ordering the Oncotype absolutely was related to cost. He was clear that if I had already made my mind up against chemo, the test was unnecessary. I know that I made the best decision for me based on the info we had at the time. I wish the TailorX results were coming sooner to help women today who are in the same boat I was in two years ago. 

That is exactly what happened to me.

Seriously my last words before surgery were, Order the Oncotype.

(actually they were, oh you are from Edina, MN...but you get the idea)

Because I had a pos node the surgeon did not do that.

Oncologist did.

Surgeons are not oncologists.

Warrior Woman, you made the best decision you could with the info at the time. Science progresses, but don't beat yourself up no matter what. (Easier said than done I know, I want my freaking nodes back.)

I would suspect that the intermediate range will get higher.

For ER+ cancer that is the way the science is moving.

As my onc said, you are not going to see a study saying chemo has more of a benefit than we thought.

I am going to mention again to ask for the report when you get your test result. You get to see all the components that make up the score. Plus you get charts with the error range.

Again I am 4 years out....I could be out of date, but my understanding is "low" has move up over time from 14 to 18....meaning more women are not getting chemo... 

Maybe the same thing will happen on the other end...some women will move into high.

I would think data would move women out of the grey zone...but maybe I am wrong.

warrior...The purpose for lowering the range that will  randomly be receiving chemo in the TailorX study was to "see" where the benefit of chemo occurs.  So, if you had a hundred patients who had a 12 score with 50 getting chemo and the other 50 not receiving chemo and all did well...then we would conclusively know  that for low scores of 12 there is no need for chemo.  Now, as the other scores are randomized, we will hopefully know' as we approach the 18- 25 scores where chemo finally does help.  Then, we will be able to get more patients out of the dreaded "intermediate" zone.  The bottom line for now is that until we get the TailorX results, too many intermediate range sisters cannot know whether chemo will benefit them.  Likewise, based on the current Oncotype scores below 18, there is little or no benefit of doing chemo.  Another interesting point is that many patients like myself are anxiously waiting the results of the SOFT trial. The patients who are participating in the SOFT trial are at low risk of recurrence.  The early word coming out of the trial is that there have been fewer recurrences than what they expected.  It seems reasonable to think that once TailorX is reported, there might be fewer recurrences as well and that might be good news as well. Maybe many more intermediate  patients will find themselves pushed into the low OncotypeDX range.  Now that would be very good news!