Is Oncotype testing done for DCIS?

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Scsa
Scsa Member Posts: 26
edited November 2015 in DCIS (Ductal Carcinoma In Situ)

Is Oncotype testing routinely done for DCIS? I recently had a lumpectomy for DCIS and I was not told it as done. Should it have been done - family is asking me about it. Thanks!

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited November 2015

    There are two distinct Oncotype tests - one is for invasive cancer and one is for DCIS.  The test for invasive cancer provides information on whether the addition of chemotherapy provides benefit when added to anti-hormonal therapy.  The Oncotype test for DCIS is a predictor of recurrence and helps physicians determine which types of treatment, such as radiation and anti-hormonals, may be appropriate dependent on risk.  The Oncotype for DCIS is a newer test so it may not be routinely done by your physicians or center.  Here are links:

    http://breast-cancer.oncotypedx.com/en-US/Patient-Invasive/WhatIsTheOncotypeDXCancerTest.aspx

    http://breast-cancer.oncotypedx.com/en-US/Patient-DCIS/WhatIsTheOncotypeDXCancerTest.aspx

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  • Moderators
    Moderators Member Posts: 25,912
    edited November 2015

    Hi Scsa,

    In addition to the helpful links SpecialK provided, you may also want to check out the main Breastcancer.org site's page on Oncotype DX Testing, which explains the difference between DCIS and invasive cancer testing.

    We hope this helps!

    --The Mods

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  • windingshores
    windingshores Member Posts: 704
    edited November 2015

    I was told by MD's that DCIS is always HER2 positive. That would mean the DCIS Oncotype test is different and doesn't include HER2. Has anyone else been told this? (In fact, I was told this in the context of a positive HER2 result from the biopsy, which might have included some DCIS tissue mixed in with invasive. I had them redo the testing after surgery pathology was negative for HER2, and got another negative the second time.)

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  • Annette47
    Annette47 Member Posts: 957
    edited November 2015

    DCIS isn’t always HER2+ but it is much more frequently than invasive cancer. HER2+ in DCIS doesn’t appear to signify the same level of aggressiveness as it does in invasive cancer and doesn’t need to be treated any differently, so many places (mine included) don’t bother to test the DCIS portions for it (in my case my micro-invasion was too small for them to test that portion for it).

    I’m not sure how that affects the DCIS Oncotype test though, but as others have said I do know it is a different test than the one given for invasive cancer. The Oncotype for invasive cancer is supposed to aid in determining whether chemo will be useful or not, while the one for DCIS is supposed to aid in making decisions about radiation.

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  • CAMommy
    CAMommy Member Posts: 437
    edited November 2015

    nope, not tested.

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  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited November 2015

    Hi:

    While the Oncotype test for invasive disease has been incorporated into consensus treatment guidelines for breast cancer, such as the NCCN guidelines, to my knowledge, the test for DCIS has not yet been incorporated into the NCCN guidelines. This may reflect that the DCIS test has not been studied as extensively (validation). Please confirm with your providers.

    If you have questions about it, please do not hesitate to ask your providers whether it might provide useful information in your case, or if not, why not.

    The Oncotype test for invasive disease measures expression from 21 genes (16 cancer-related genes and five reference genes).

    source: http://breast-cancer.oncotypedx.com/en-US/Professi...

    The Oncotype test for DCIS measures expression from a subset of the genes used in the invasive test (21-gene test Recurrence Score assay):

    source: http://link.springer.com/article/10.1007/s10549-01...

    "The Oncotype DX® DCIS Score is a multigene expression assay for DCIS patients that generates individualized estimates of 10-year risk of any LR (DCIS or invasive) and invasive LR following treatment by BCS alone [39]. The DCIS Score is generated from an algorithm that includes 12 (seven cancer related and five reference genes) of the 21 genes in the Recurrence Score assay [30]."

    The particular genes tested for expression in the DCIS test are shown here in the Gene Selection Figure:

    http://breast-cancer.oncotypedx.com/en-US/Professi...

    BarredOwl

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