Tumor Grade and relationship to chemo recommendations
Does anyone know if having a Grade 2 increases the odds of having a higher Oncotype DX score? I was staged at 1A, grade 2 and my tumor size was under 1cm. Does the grade also influence whether chemo is recommended?
Comments
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It would be a factor, but Grade 2 is not highly aggressive. Bottom line will be the Oncotype DX score. Good luck!
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While grade is often highly indicative of what category your score will be in, there is no way to predict, especially if you are Grade 2. While most Grade 1 tumors are catatgorized with a low or intermediate score, a small percentage are categorized with a high score. The same is true of Grade 3 tumors. While it is common to see them categorized at intermediate or high risk scores, a small percentage are Grade 1. With a Grade 2 tumor, there is Noway to predict. Furthermore, if you find out your score is in the intermediate category, the TailorX trial, whose preliminary results will be known in a few years, may be helpful in getting those with intermediate scores out of the intermediate category and give more direction as to whether one would need chemo.
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My tumor was slightly bigger than yours and I was grade 2 and also stage 1. My oncotype was 17. I did opt for chemo because my tumor pathology indicated lymphatic invasion.
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I don't think I got the oncotype test. Wonder why?
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Here are some very interesting graphs from Genomic Health related to this subject.
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I had a stage 1 grade 2 tumor as well. My oncotype came back at 19. I also had LVI so I did the chemo!
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I was grade 2, 1.3 cm tumor, no nodes - Oncotype score of 42. Everyone was shocked. My IDC is an aggressive subtype of ER+ IDC called Luminal B, which includes ER+/PR-/Her2- and a high proliferation rate (measured by Ki67, part of what makes up the Oncotype test, and likely what makes my score so high). So while it would make sense (and is often the case) that a grade 2 cancer will have a lower Oncotype score, there's no real way to predict.
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dogs...your Oncologist typically orders the test. My Oncologist was ambivalent about my treatment plan so she ordered the test. My BS was positive with the micromet in my SN I would get chemo. My Oncologist wasn't convinced given my tumor was not that large and I was Grade 1. There is no way to predict what your score would be but I am so grateful she had me take the test. As a result my score came back 11 and I had 33 RADS treatments. They were a piece of cake compared to chemo. Maybe your oncologist didn't think the outcome would make a difference in your treatment plan and was concerned about the grade. Ideally you want the tumor to be Grade 1 but as others have said even that is no guarantee your score will be low. There are other factors to consider. Diane
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Thanks for the explanation!
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