NEW Oncotype Dx Roll Call Thread

my Oncotype score was 23, but I had a positive node. Based on the positive node, docs recommended chemo. I wouldn't have had chemo if it weren't for that positive node. I was 48 at the time of my diagnosis.

The Oncotype brochure is excellent. The Oncotype results are presented like this when you get them. I do not believe that most women realize that chemo is giving them only a 1 or 2 out of 100 advantage.

I found that this table from the Sparano paper setting up the TAILORx study was really helpful. I'm not an MD. I'm a PhD scientist and I know my way around a table and a graph. A p-value of 0.54 means no significant effect of chemo for the 11-25 RS. In this retrospective dataset. That's why the results of TAILORx will be so important. There is a very strong beneficial effect with higher recurrence scores, that is clear. I read all the primary literature I could absorb, listened to all the arguments and made the best decision I could make for me. For those of us in the grey zone (I'm 20), it's the best we can do.

From Sparano, Joseph A. "TAILORx: trial assigning individualized options for treatment (Rx)." Clinical breast cancer 7, no. 4 (2006): 347-350.

Yes thank you. I think this is true in general but when I got my own individual info and graph from genomic health, my info indicated 5-6% benefit. Looking forward to these study results too.

Lori, that is great! Congrats for investigating further and looking at all your options!

18 months out with Oncotype of 19 - just had recurrence in axillary nodes.

I am so glad that this thread is still live. This helps all of us make good decisions.

famerjo

With this: Oncotype 19 Ki67 29.1% ER 90% PR 5%, I'm very curious how the Oncotype score reported out your ER and PR - I assume the 90% and 5% are from your biopsy? Btw, exactly the same %'s I got for ER and PR from initial biopsy, though my Ki67 was 60% causing my score to go to 39. My oncoscore also reported back a mediocre ER, compared to the 90% I got on the initial biopsy. To be honest, with what they consider a high Ki67 (> 12%), I'm surprised your oncoscore is middling, but maybe your high ER saved you. Also, high ER and low PR is a more aggressive than having high ER and high PR (luminal .

Sorry about your recurrence in your nodes. Do they think it was missed or a recurrence?

Meow

Not sure you are referring to a question I had, as it sounds like my kind of question or comment, but we have a similar Dx and you are only a month ahead of me on that. Congratulations on skipping chemo! Was that against doctor's orders? Can I ask the size of your tumor (mine was 1.4 cm)? I have permanent neuropathy from chemo and it makes things I love to do unpleasant. If I could have seen a crystal ball that resulted in chemo not working or making a difference, then I would have been happy to skip chemo. Something I'll never know.

ER+ PR- tends to result in a high Oncotype Score, that along with low ER (and/or low PR) and high Ki67.

My Nottingham was 8/9 - I know my mitotic was 3, so that's where I beat you out. (My oncoscore was 39.) I assume mitotic correlates to Ki67...mine was high at 60%. ER+PR- is considered luminal B. ER+PR+ are luminal A. Lum B worse than Lum A, but better than triple negative!! My MO seems to think Her2+ is good because there is herceptin - a conundrum. After 5 years, our risk is the same as a luminal A, or so I've read. The problem with that, while it sounds great, it seems lower risk cancer happen later!

My cousin had ILC hormone positive. She skipped hormone blockers, except the lumpectomy and radiation, against doctor's orders. She must be about 8 years out now. (I don't think chemo was recommended for her and she never had an Oncoscore - she lives in Canada - not saying that is why, but might be part of it.)

i need to qualify something.....can be er+pr+, but high ki67 (gt 12%) and be luminal B, but for some reason I think the low pr, but still present, comes with more aggressive breast cancers. Does that make sense (one finger typing on an Ipad, so can't say all).

I can't really answer your question farnerjo about AIs not helping much with low PR values....Ive seen so much contrary info on subtypes and this, but i just posted a link to a video on (wiil you be doing 10 years of AI thread) and some MOs were wondering outloud whether some breast cancers in the luminal A category needed any hormone blocker treatment at all (and no chemo, definitely)...they used, i think, a cutoff of 11 on Oncotype, but to the contrary the rest of us should definitely be doing AIs!!

I would also say, if hormone blockers always worked on hormone positive cancers, then there would never be recurrence or mets, and that is not happening

I was wondering if we could wake this thread up again... so scared

How differently are people reporting? Some may be citing the top of the Confidence Interval (CI) rather than the middle of the upper and lower band. I think it would be more typical to report the middle of the CI band per how the recurrance rate is presented. Some might be subtracting 2% from their recurrence rate for taking Aromatase Inhibitors rather than Tamoxifen. Some might be reporting their recurrence rates with the chemo benefit factored in, but I think that would be improper.

That is odd. I would not expect the "10-year Risk of Distant Recurrence with Tam Alone" that is printed to the left of the first graph of the node-negative reports to be different for the exact same Recurrence Score.

This is because to my layperson knowledge, the same data set has been used since inception of the test (i.e., the results of the node-negative NSABP B-14 study by Paik (2004)) to provide 10-year distant recurrence risk estimates with Tam Alone.

The report title at the top of page 1 should indicate that it is a "Node Negative" report if you are node-negative:

In the node-negative report, the title of the first graph refers to the NSABP B-14 source study. In this sample, the Recurrence Score was 10 and the 10-year risk of distant recurrence with Tam Alone is 7% (CI: 4% - 9%).

BarredOwl

Hi Bessy, my Oncotype score was also 22. My MO was quite sure that chemo was not worth the risks. She didn't say anything about the recurrence rate being lowered to 8%, I understood it was just a 2 or 3% reduction. However I don't know the details of your diagnosis i.e. grade or node involvement, would you be able to add them to your profile?