should I have had an oncotype test?

I never had one and my doctors have never really discussed it with me. I'm not really sure what it means. I've read all sorts of posts on here about people who like knowing their score and others who don't. It's kind of like the tumor marker test. I did one and it was normal but my cancer was back and staged at 4. So I am one of those who don't put a lot of emphasis on those types of tests. Maybe someone who knows more will come along a post for you. Sorry not to be much help! I wish you lots of luck and peace. 

I had it done, yes it is for determining if after your Lumpectomy/Radiation or your Mastectomy (whichever you have) - if you would get a benefit from CHEMO or if Chemo would not really add much benefit..

I have Inv Ductal & DCIS in Right Breast - I wanted to avoid Radiation as my skin is very sensitive, I have had many many sun burns on my chest and have Rheynaud's Syndrome (I get very cold and hands, feet turn white and when I go in and out of cold air or very hot temperatures I get either freezing or my hands and feet turn bright red) -- had that since teens, not harmful - I just always have sweater with me in my Big Handbag!  and always wear lots clothes in winter,,,  anyways - I met with the Radiation Oncologist right after I met with the Breast Surgeon to discuss even if I was a candidate for Radiation - I also have had several squamous cell carcinomas (from too much time in the sun) and those happen to be above my breasts on my chest - - and fair Scottish skin and lots damage - so he met with me - went over my family history and my own health history and he could see how cold I was in his office in May - they had the AC on high and I had sandals on and he said wow your feet really are purple/blue and that concerns me with how sensitive your body is - I kept my mouth shut (as I already had in mind going with Mastectomy vs a lumpectomy + Radiation as everyone I know or have heard that begins with  Lumpectomy & Radiation ends up getting more something 2-3 yrs later and needs the Mastecomy and reconstruction anyways,,,,  (I know some women do the Lump/Rad and never have a recurrence however, I know about 8 women who had that first and all wound up needing the Mastectomy so in my opinion - it was best for me to just give me peace of mind that the dense breast tissue that has given me issues in past - 7 yrs ago had scare for BC that was false alarm and had sterotactic biopsy then and then same area in 2014 - two biopsies - and DX of IDC/DCIS.  so I was leaning to MX on one side from the beginning in my own head,,  He came right out and said well I think your best option would be a Mastectomy of the Right and if you would get more peace of mind removing both, fine - but I think you'll be safe just removing the RT as your left seems to have no indication of any cancer in it - this way you keep the Left, have a natural breast and feeling and do reconstruction on Right and don't even consider Lumpectomy & radiation as Radiation probably would burn you and more risk blisters and itchy and all the Radiation issues nor need to go in 5 days week for it for 6 wks...  (I was glad he confirmed that my gut instinct felt I would not do well in radiation and glad he advised what I was thinking was best as well).

anyways - the one ???  left was in my tissue sample from the June surgery - the Breast Surgeon did Sentinel Lymph node biopsy (only took out the SN) - said looked good so felt no need to remove any others...  that the tracer dye went straight to that one node she removed. - so that was good news as if was in it - then more nodes would have had to be taken out and examined and I would def need chemo

so the ONCA test gives ONC the score - a prediction based on your stage, grade, tumor size and tissue samples and age of DX and gives a recurrance score so if it is on the lower side - maybe under 25 or somewhere near there,,  then DR may say ok Chemo would not benefit you - but if recurrance score is higher side - say 48, they would likely say yes Chemo is in your cards...  will help you.  Mine was 9 - so they called and said good news - No Chemo!  so that was a blessing.

I don't know if every insurance pays for the ONCA DX test and if maybe it is paid for if the patient is under 45 and in early stage 0 to 1, I believe there was some criteria that made DRs say you are a candidate for ONCA DX testing and it is covered so we are doing it...

I also am not sure if the test can be done at a later date or only when you have your surgery... 

Glennie, you can ask your DR about it though - that would make sense to ask them...  can't hurt to ask, right! your BC info is not PUBLIC so I don't know what stage, grade, ER/PR+ or HER2- you are etc (you may like to make your profile public in settings so when you post - others know what your DX is)... 

KITE,  u are HER2+ and ER/PR- (ONCA tests I believe are done on ER/PR+ cancers and not HER2+)... most likely why you hadn't had it maybe..

Glennie, How are you feeling now? one year out!  are you or have you gone for your one year follow up?  are you getting a MRI - if you have a natural breast left - my DR suggests that at 1 yr out (shows everything)..  hope you are doing and feeling well! 

Different Drs have differing thoughts on the usefulness of them.  Apparently there are many variables with using it or not to decide what treatment should be.  My Chemo Dr said he does not do them usually as they are unreliable - often giving a false sense of security or raising unfounded fears.  I have not had them.

Just to clarify...you do NOT have to be post menopausal for the OncotypeDx test. The general indications are early stage, Er/Pr+, Her2- IDC or ILC (IBC always gets chemo from what I've read). Until recently it was only for node negative, but they're now sometimes using the test for one or two nodes positive. The "break point" for chemo is usually around 18-20 (higher and chemo is recommended, lower and it's not) but it's a decision making tool and it's ultimately up to the patient. A new study (TailorX, I think) is evaluating the middle zone scores (13-30 or something) and whether chemo is beneficial but the data aren't out yet.

Thank you to those who have corrected some of the misinformation posted on this thread i.e. It's kind of like a tumor marker test, it's for post-menopausal women. A good source of info is the patient portal on the web site of Genomic Health, the makers of the Oncotype DX test.

http://www.genomichealth.com/en-US/OncotypeDX.aspx...

With IBC, there is no reason to do an onco test as it is basically never a question of rather or not chemo will be the first step - it is.  IBC is different than other types - it forms in 'nests' or 'bands' so neoadjuvant chemo has to be done to get it to form into 'lump(s)' with margins so surgery hasma hope of getting it all, also to shrink it.  Some will do 2 different batches of chemos neoadjuvamt and a few of us will do neoadjuvant AND adjuvant.

johnsmith - glennie had stage 0 cancer, chemo was not appropriate for her, so the test was not necessary.

The purpose of Oncotype Dx testing IS for the prediction of distant recurrence risk, not local recurrence. The reason to do chemo is to stave off distant recurrence while surgically removing cancer in the breast either before or after, it is not really for preventing local recurrence. See the attached link for some info on this:

https://www.adjuvantonline.com/breasthelp0306/OncotypeDxTest.html

Here is a link to an existing thread that may address your Oncotype and recurrence question:

https://community.breastcancer.org/forum/108/topic/804724?page=1

I had the test done. My ONC ordered it because I had a micromet in my SN. She said women have been over treated for years, thus the test. My score was 11. I had 33 RADS treatments. Fortunately BCBS paid for the test. I am post-menopausal. I have IDC Stage 2, Grade 1. 3 1/2 years out taking Tamoxifen. I dodged chemo because of that test. 

Diane