ONCOTYPE TEST and FISH TEST

It seems unusual to me that Oncotype Dx testing would happen without definitive results from FISH testing.  FISH is to determine Her2 status, and Oncotype testing is not done on Her2+ samples.  Until the Her2 status is known Oncotype should not be done.

See if your facility has a patient portal. Get an account and login to see if any of your reports are on there. If I remember, FISH gets sent out, so takes about a week. For me, my cancer diagnosis came about 24 hours after my core biopsy, the Her2 came a week later, but I don't think anyone told me or told me what that meant. Then 16 days later I met with the MO who told me HER2+++, that he had the tumor sized again based upon the MRI, not the mammo and US, so now it was over 2cm, putting me at stage II and I would need chemo since it was Her2+++. Mind you, getting it over 2cm, allowed me different therapies, but still. Threw me for a loop. No one had mentioned that.

Actually is is very common for cancer to be larger on final path than biopsy. I was glad I was warned to expect that.

That is a good thing!

I had to wait 2-3 weeks for my oncotype score to come in and the MO would not give me the results over the phone. The only thing that changed on my final pathology was the grade of the tumor (I actually had 3 small tumors) it was upgraded from grade 1 to grade 3, which is the main reason the MO ordered the oncotype test and he didn't even order it until after I met with him for the first time. I knew hormone receptor status right away but had to wait a few days for the HER status.

The waiting is the hardest part, hang in there!

I'm sure that's a huge relief!

I'll bet, Florida! Do you know yet which AI you'll be on? I hope it works out very well for you.

Are you going to start it after radiation? I think that's usual but I'm not sure there's any particular reason for it. At this point I'd be afraid to stop Femara for the duration of rad.- have to ask my BS or MO about that, eventually.

At any rate, enjoy your weekend knowing chemo isn't in the cards!

I had a lumpectomy, and am healing fine. I have IDC- I'm 51, and pre menopausal. My pathology report says I am stage 1A, grade 3, ER+ PR+, HER-, nottingham score 9, KI 67= 60%, and I'm waiting on the oncotype dx (genomic) test results. I was wondering if anyone with a grade 3 (aggressive) got a low number? I'm really scared of the thought of enduring chemo.

I am grade 3, high KI67 and low Oncotype score of 8. I am 95% estrogen positive. The discrepancy makes me nervous.

You're right. It gives the % chance of recurrence, but it also studies 21 genes and how they will respond to treatment, which is how they know whether we need radiation or chemo or both, right? So, it analyzes and predicts. I just thought since if they would treat us with chemo with a high chance of recurrence (could be same area, or in the brain, eye, liver, etc...) and, since the chemo works in the bloodstream to kill cancer that may have traveled elsewhere or be in the process of traveling elsewhere, isn't that metastasizing?. Otherwise, why would we take chemo? I guess I'm not understanding something. I mean, isn't the radiation more directed at killing the area where the tumor was in order to prevent recurrence in that same area; whereas, chemo is meant to go throughout the body and look for and kill it where EVER it might be because the high number suggests it? I'm sorry. I'm so new to this, and have so much more to learn. I'm a little slow too.

Good for you to keep trying, and finding one you feel comfortable and confident with!! I see your concerns. I am concerned that my Oncologist, while seeming very compassionate, already told me I would be taking Tomoxifen, which must be standard at this point, I suppose. One of the side effects of this pill is ovarian cancer. I was reading that there is a drug (starts with an "A" can't spell) that does the same thing without that side effect, so I was questioning why the doctor was so adamant that I'd be taking it before my test results came back. I am happy for you, and I do wish you the best!!

Shanann,

I wanted to let you know that the Oncotype Dx recurrence score is only relevant to whether or not CHEMO is beneficial to you.  In the Oncotype DX trial all women took tamoxifen for 5 years, so the Oncotype DX score assumes that you will take 5 years of tamoxifen.  Therefore, it has no relevance on your decision of whether or not you should be taking hormonal treatment.  For women with very low Oncotype scores, they may be extremely responsive to hormonal treatment (and hence low Oncotype scores and NO CHEMO), but if they had not taken the hormonal treatment, their recurrence rates would be much higher. 

I keep writing on various threads about this distinction, because it seems to me that many women are putting too much stock into this ONE number in their treatment decisions, and especially when they are deciding to forego hormonal treatment - as stated above, the Oncotype DX score has NO relevance as to whether or not a patient should have hormonal treatment - it is only relevant as to the decision with respect to chemotherapy.

Also, as you know tumors are made up of cells, and one or more cells break off the tumor and go into the bloodstream, when the cancer is invasive.  Many of these cells do not survive their travel in the bloodstream, but some do.  The only method that a cancer cell could go and metastasize in some other part of your body is NOT through the lymph nodes.  These cells also enter and travel directly through the bloodstream.  A single cell that survives may cause a future metastasis. All systemic therapies target these cells that have escaped the tumor - anti-hormonals, chemo etc.  If you have a lumpectomy, the radiation is necessary. If you have a mastectomy, radiation may or may not be necessary depending on your margins and whether or not you have lymph node involvement.

I am so sorry you have found yourself in a place where you have to make all these decisions.  I hope your treatment goes very well.  Chemo is not as scary or bad as one imagines.  After my first infusion of AC, I went out to dinner with friends.  The modern anti-nausea medicines are extremely strong and work very very well, as well as all other "support" medicines given during the chemo.  I personally hate nausea, and was very happy that the medicines worked so well.

https://www.breastcancercare.org.uk/breast-cancer-...

It may cause ovarian cancer and/or polyps. I have read that it might also cause Uterine cancer. Both my mother, and her sister had uterine cancer, and my aunt died from the disease (she refused to be treated until it was too late). Since it runs in my family I am greatly concerned.