Need Oncotype DX Test

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Sophrosyne
Sophrosyne Member Posts: 19
edited September 2015 in Waiting for Test Results

Hello everyone,

It seems like a long road and a lot of waiting so far, but it's really only been since July 30th (diagnosis date). Had several biopsies including MRI biopsy, then lumpectomy and sentinel node biopsy on 8/24 in right breast. Apparently I have microscopic areas of cancer in two of three lymph nodes that were removed. The surgeon said negative margins, hormone positive and everything else is good, but will need another test that the Insurance company won't cover for a period of time after the surgery....something like Oncotype DX? I don't frigging get that! Why would a patient have to wait to find out how sick they are or what the treatment is going to entail!. I am really frustrated. I will see the oncologist on Tuesday and she said he might be able to order the additional test then. I am told I will need radiation and hormone therapy for sure, but the chemo will depend on the results of this test. From what I have read about chemo, I'd almost rather die (almost). I don't want to be forced to poison myself to make myself well. I know this sounds over dramatic. I just never (in a million years) imagined I'd be here. I exercise and eat right, maintain a semi healthy weight.....WTF? Sorry for the rant and thanks for listening.

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  • dtad
    dtad Member Posts: 2,323
    edited September 2015

    hi there. These damn insurance companies! How can they possibly dictate whether or not you can get this test! It is very beneficial in determine how your specific cancer will respond to chemo. Whether or not you decide to take it is a personal choice but this test is crucial in making that decision. I would fuss and fight for it. Good luck

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  • PatRN10
    PatRN10 Member Posts: 332
    edited September 2015

    You will get a call from the Genomic Health Company if the test is ordered. They have a very generous assistance program. Why don't you call them and ask the customer service rep if you can talk to someone who can help you with financial questions. I had to call several times on test results and they are very responsive and pleasant.

    http://www.genomichealth.com/OncotypeDX/Index.aspx?Sid=33#.VetcSOlLhok

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  • dlb823
    dlb823 Member Posts: 9,430
    edited September 2015

    Oncotype DX is a very standard test these days, and the fact that your ins. co won't cover it immediately but would in the future makes no sense, unless there's something very unique about your insurance limitations.. I wonder if the problem could be as simple as a coding error? If chemo is recommended (and it may not be, so don't get ahead of yourself), finding out weeks from now would very likely negate the benefit of doing it, so okay'ing it in the future makes no sense. Hugs, Deanna

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  • Sophrosyne
    Sophrosyne Member Posts: 19
    edited September 2015

    Thank you all so much for your replies. If my oncologist can't request this test Tuesday, I will follow up with the insurance company and insist. I do not want to do chemo, but if it's necessary, I need to know sooner rather than later. Seems like every thought I have these days is "I just want to get this over with". That's just sad, but I want to get on with living and not dwelling on being sick. Every day, my Mother calls and asks me how I'm feeling. I am not sick, yet I have cancer, I feel great yet I have cancer. If getting well is going to make me sick, I want to get it over with.

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  • Sarah0915
    Sarah0915 Member Posts: 94
    edited September 2015

    This test could be very helpful in making a decision on whether or not chemotherapy is needed. But, as I recall, it is a very expensive test. My insurance wouldn't cover it back in 2009 but the company's patient assistance program covered the entire cost even though I had a very decent income at the time. It is certainly worth checking with them if your insurance company refuses. Genomics appealed my insurance company's refusal for me at least 3 times I believe. Good luck and I hope things go well for you.

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  • keepthefaith
    keepthefaith Member Posts: 2,156
    edited September 2015

    sophrosyne, I hope you can get the test done soon. Your MO should be able to push it through. There are guidelines that your MO will want to follow to start chemo within a certain time frame following surgery, if chemo is recommended, but it is not a real short time. I think I started chemo about 6 wks from my LX. The waiting is very hard. Where are you, in Texas?

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  • coraleliz
    coraleliz Member Posts: 1,523
    edited September 2015

    Genomic health checked with my insurance copy & I was told the test was not covered. But that they were contracted with my insurance company & I would not incur any charges. Huh!!!!! They sent me this in writing also. It turns out my insurance picked up the whole tab. Makes no sense.

    Sometimes I think they just wanted my tumor "data". Because at the time, the oncotype for node positive women wasn't very well accepted. Clinical trials were just starting. I'm not sure if they can track what happens to me. I'd give them the info if they'd ask.

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  • Sophrosyne
    Sophrosyne Member Posts: 19
    edited September 2015

    Grand Prairie, TX

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