average wait time for oncotype results

Juniper, seems long to me...maybe the thanksgiving holiday has caused delaye? It should take no more than 3 weeks.

MsP

I would request that your doc contact the lab. Sometimes the results don't get sent, or are sent and lost. There are two separate tests, one for invasive cancer and a different one for DCIS. Since your invasive component would be more likely to drive systemic treatment decisions, it is less likely that the DCIS testing would be done.

my experience was the same as Brookside. Once the MO ordered the test, it was three weeks. The oncotypelab is in central California and they physically send the tumor sample to the lab. There could have been a delay with the pathology lab sending the sample or it might be longer ahipping time than mine since I live in Southern California.

Have you met your onc/MO yet? If not, you can ask for an appointment. They set me up with the MO (systemic treatment) and RO (local treatment) both on the same day, one right after the other. It was great in that I had a good understanding of all the treatment they had in mind for me, including the possible chemo. It was a lot of information, however. My onc (who clearly had experience with zero retention patients) actually took notes and sent them home with me!

By the way, there is probably no rush (in their minds, at least) for this result. The normal routine is that you will have rads once your incision heals, then either chemo or an anti-hormonal Rx. It will therefore be a month or two before you can start chemo (which we all hope you will not need).

I had lumpectomy for IDC on Dec 4th, the two nodes removed during surgery were bad so my surgeon removed more....she called me this past Thursday and said that out of 24 extra nodes removed only 1 tested positive and it was sent for oncotype and I should have the results by Jan 6th ...when I made my appt with onc, I asked if they thought it would be back and they said it should be.....so I think you are waiting a little to long , call your docs and check up on that.....good luck, stay strong.....

My result took less than 2 weeks last year. The lab also called me about finance and were extremely helpful. They even put me through to the tech who was running my test to tell me how it was going and answer any questions. He also told me that my mo had an account where the results would be posted without him waiting on a call or mail. If your sample has indeed be sent you could try contacting Genomic Health. They really were exceptionally helpful to me.

Hi:

This is my understanding as a layperson. The Oncotype test for DCIS is not offered to patients with invasive cancer (in the same breast). To the extent that the DCIS test has been assessed for its ability to do its job, such testing has been in patients with pure DCIS. See for example:

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

In patients with pure DCIS, the DCIS test is used to aid in decision-making about radiation therapy in patients treated with breast conserving therapy. In some DCIS cases, it may be appropriate to skip radiation therapy.

In contrast, with limited exceptions, the NCCN guidelines provide for radiation therapy with all invasive disease treated by breast conserving surgery, even if node negative.

The above is why the DCIS test is not offered to patients with invasive disease (in the same breast).

For those with pure DCIS, the DCIS test generates individualized estimates of 10-year risk of any local recurrence (DCIS or invasive) and invasive local recurrence following treatment by breast conserving surgery alone. Not all DCIS is HER2+, but in any event, HER2 status is not relevant for the DCIS test. The eligibility requirements for the test for DCIS and invasive cancer are not the same. Regarding Oncotype for DCIS, the eligibility requirements are described here:

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

• For women with ductal carcinoma in situ treated by local excision, with or without tamoxifen.

The above is probably a broader statement than what occurs in practice in the clinic at this time, due to the characteristics of the patient populations in which it was tested (selected DCIS patients). In addition, the test for DCIS is still not included in the 1.2016 version of the NCCN guidelines for Breast Cancer.

Nevertheless, anyone interested in the Oncotype test for DCIS should not hesitate to ask their medical oncologist for current professional advice regarding eligibility and the potential utility of the test in view of their particular presentation.

BarredOwl

[Edited later to add clarifying statement: "(in the same breast)"]

Didn't hear anything about test results last week, but did get a call from Oncotype people making sure I could pay the portion of charges not covered by insurance! The billing person told me she would have someone from the lab call me re: actual test status, but that didn't happen.

So I called Oncotype this morning, and was told that my tissue sample has never been received. My onc's office knew that the sample had never been received, they implied. Onc's office, each time I've called, just kept asking me to call back for status.

When I contacted them today, they said that a billing issue was holding us up (wrong). Then they said that lots of patients' results have been delayed due to the holidays. They they said that the Oncotype folks are undergoing some "changes" (organizational? financial?) that caused the lapse.

I am so angry and frustrated. I can't plan anything. Treatment has been delayed. Is this dangerous, health-wise? At least two doctors have told me to proceed...but I can't! Lumpectomy was Sept. 3...and on Dec. 28 I STILL don't know what I am dealing with, for God's sake! Don't know why Oncotype wasn't requested long before it was. Don't know why my BS told me I didn't need the test -- and my tissue sample was too small anyway -- and then onc had completely different take...then his office has messed the whole thing up and failed to communicate.

While some aspects of this journey have gone well, others have been so scary and upsetting. If I had to describe this part of it, the title would be: Don't let this happen to you. Don't assume that even doctors with good reputations (or their staffs) will connect the dots. Stay (politely) on top of everything.

Thanks for listening. I usually try to stay pretty positive, but it's hard on this particular day. This kind of situation probably isn't unusual...it just feels BAD.

Doxie: The waiting has been awful, and draining, but the possible health compromise is what worries me. I had my lumpectomy on Sept. 3...four months ago. Sentinel node biopsy Nov. 19. Am I still okay? Stage one, tumor very small, path report said low mitotic rate and no LVI. But still....Just want to get the treatment, whatever it winds up being, underway. I wouldn't wish this on my worst enemy.

Girl53, What has happened to you is beyond unacceptable and you are right to be steaming mad and concerned about your health. Why would you trust an oncologist who has a bunch of lazy uncaring people in their office who lie?? I was steaming mad when I found out that the tissue the lab sent to Genomics after my surgery didn't have any cancer in it. WHAT! I was told by my surgeon who ordered the test to just let my oncologist handle everything. NO WAY! I contacted the lab (I still have to thank the kind lady on the phone who gave me the direct line to the technicians) and they corrected the problem the same day and told me that they would expedite with Genomics. Not to leave anything to chance, I called Genomics the next day to confirm that they had my sample, it was expedited and then I called later to confirm there was cancer in the sample. I'm sure my oncologist wouldn't have gotten things done as fast as I did. Although I have always been a control freak, the whole cancer process has reinforced to me that the world is full of incompetent, uncaring people and we have to over-function to compensate for their lack of skill, lack of attention to detail and overall general laziness.
Get mad and get loud!!
MsP

Girl53,

You may be correct on PR- putting you into the intermediate zone. Mine was only 5%, but what likely pulled it down also was a very high Ki67.

I had better day yesterday with the waiting, now am feeling upset and on edge again today. Trying to be patient with myself and say, "I am developing new emotional and spiritual 'muscles' that are healthy here and will help me in other situations, too." So good to know none of us is alone. Am praying for somewhat less uncertainty in the New Year.

The reason that only one place does this test is that they were the ones that developed the theory and what criteria to look for. I believe it is like drugs that are protected for a number of years before generic ones can be made. The original manufacturer gets to recoup some of their investment before others have access to the process. I had to wait until I met with the MO before the test was ordered. It seems to me that the tumor should be automatically sent for testing after the original surgery. But on the other hand, my MO would not have ordered the Oncotype DX test if I had not been willing to have chemo if the test recommended it. My Oncotype was ordered two months after my surgery and then the results came back two weeks after that. And that was in the month of December 2013 with holidays. Best wishes to those waiting. Waiting is the hardest part of all.

They usually don't send off a sample for Oncotyping until they have a path report with full information as to ER/PR//Her2 status, size, grade, mitotic rate, nodes and margins. My BS' nurse explained at my pre-op “teaching session" that Oncotype testing is usually not done for Stage IA tumors so favorable that chemo is obviously unnecessary, nor for tumors showing signs of aggressiveness such as hormone- or HER+ status, grade 3, node involvement, non-clear margins, and size. They save it for those in a “gray area," where a grade 1 or 2 tumor may be >1cm but <1.5, have PR- but ER+ and HER2- status, have only one positive sentinel node, and need a second pass to get clean margins. MOs like to meet with the patient first to discuss this, since not all insurers cover Oncotyping 100%; yet such tumors may or may not even respond well to chemo, because chemo works best against fast-dividing cells.

Mine was in a “gray area" because it was 1.3cm, though the ultrasound predicted .7 and the biopsy .9 at most. My surgery was 9/23, I got the path report 9/27 and met with my MO 10/1. She said she was 90% sure I wouldn't get any benefit from chemo, but Oncotyping was a good idea to make certain. I agreed, and got my score back 10 days later--16, or near the upper end of “low." By that measure, adding chemo would have lowered my 15-yr, chance of recurrence by only <1% over that of radiation + AI alone. (Recurrence, not survival).