Oncotype & ILC
Is there any truth to someone telling me that the Oncotype test doesn't work as well for ILC? I was told by my Oncologist that it always comes back low yet on here I see many women with high Oncotype scores.
Comments
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MamaDarling, I have read several of your posts/threads and I am truly sorry that you are so anxious and uncomfortable with your prognosis and treatment plan. First, there is no credible science that says that the Oncotype doesn't apply to ILC, nor is it correct that ILC tumors always come back with low oncotype scores. The oncotype is a 21 gene assay of the tumor's characteristics. . It doesn't matter what kind or size of tumor it is, only that the tumor tests positive for ER and/or PR and is not HER2 postive. You have received a low oncotype score and you have negative margins after your surgery. These are all things to celebrate. Avoiding the risks of chemo and radiation is a GOOD thing!
Hugs, MsP
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I think MamaDralings question is very relevant. ILC often "looks" quite nice - very often ki67 is also low - but it doesn't mean that lobular tumors have better prognosis than ductal tumors.
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I did not have ILC (had IDC, DCIS, ADH and ALH), but had read this post and found some study information because the concept of Oncotype and differences between ILC and IDC interested me. Here are some links that do differentiate between ILC and IDC in regard to Oncotype, pathology and treatment decisions, and prognosis:
http://onlinelibrary.wiley.com/doi/10.1002/cncr.25269/full
Particularly this paragraph:
Consistent with a previous report, this study also noted an association between low recurrence score and invasive lobular histology. Invasive lobular carcinoma is considered biologically, molecularly, and clinically distinct from invasive ductal carcinoma.16 Forty (12.7%) patients of the cohort had invasive lobular carcinoma, and 39 (97.5%) had a recurrence score <25. Regarding this histological subtype, further research into the clinical utility of Oncotype DX is warranted.
http://jco.ascopubs.org/content/26/18/3006.full
The link above discusses DFS and OS in relation to histological type - IDC or ILC. This article contains some excellent information about the differences in surgical treatment, recurrence, grade, and hormonal receptors between histological types.
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Thanks for that info SpecialK.
I have always wondered about the clinical usefulness of oncotype for ILC. I emailed a number of Genomic Health employees about the subject and didn't get much clarity. I didn't do much digging beyond my email efforts and probably won't since my wife's results are complete.
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For john smith: re your post, my oncologist noted that my path. rpt indicated vascular invasion and ordered the Onco DX test to assist him in the decision whether or not to schedule chemo for me prior to rads & AIs. I am post menopausal, 65 yrs old and on 1/14/2015 had lumpectomies on both breasts (2 ILC tumors removed on rt breast). Should my score be low or intermediate, no chemo; high would indicate that indeed chemo would be beneficial. And I find this info. quite valuable. I hope this info. might be of use to you.
Hygeia
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I just want to say that you are an amazing group of people!
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My oncotype was too high for comfort. The MO showed me various studies and said the population that they reviewed did not distinguish between lobular or ductal so we really don't know at this point.
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