Oncotype Scores

Hi Texasbluebonnet:

I apologize in advance if you are already aware of this. The Oncotype test for DCIS is not used as much as the Oncotype test for invasive disease. There are fewer people on the boards that received the DCIS test, and they may not be a representative sample of the distribution of DCIS scores.

Note that the tests for invasive disease and for DCIS differ in the number of test genes used, they are used in different patient populations (different "eligibility" requirements), for different purposes, and their recurrence risk ranges are also different.

Because of these differences, if a person has invasive disease (e.g., IDC, ILC), then the test for invasive disease is used, and their Recurrence Score cannot be compared to DCIS scores.

For example, the test for invasive disease uses 16 cancer-related genes and 5 reference or control genes ("21-gene test"). It is used in patients with invasive disease that is hormone receptor-positive, HER2-negative, regardless of type of surgery, to inform decision-making regarding chemotherapy (endocrine therapy alone or endocrine therapy plus chemotherapy).

In contrast, the test for DCIS uses 7 cancer-related genes and 5 reference genes ("12-gene test" (a subset of the genes used in the invasive test). It is used in patients determined by surgical pathology to have pure DCIS (no invasive disease) and who are treated by local excision (also known as breast conserving therapy or lumpectomy) (with or without tamoxifen), to aid in decision-making regarding radiation therapy. Eligibility for the DCIS test does not require any particular receptor status.

The standard risk categories for the test for invasive disease are:

Low-risk (Recurrence Score < 18)

Intermediate-risk (Recurrence Score 18 to 30)

High-risk (Recurrence Score ≥ 31)

In contrast, the standard risk categories for the DCIS test are different, with "high risk" starting at a higher score:

Low-risk (DCIS Score < 39)

Intermediate-risk (DCIS Score 39–54)

High-risk (DCIS Score ≥ 55)

It sounds like you have selected a treatment plan that addresses the risk information provided by the DCIS test, which is good.

Best,

BarredOwl

References:

Rakovitch (2015): http://link.springer.com/article/10.1007/s10549-015-3464-6/fulltext.html

Solin (2013): http://jnci.oxfordjournals.org/content/105/10/701

TexasBlubonnet, I hope you feel better. I received an oncodx of 34 in the invasive cancer test. The high number is so upsetting but I hope you feel better about the 70 score in non-invasive test. You are going to be fine! Do not let the number scare you. It is to help you make treatment decisions, you will be ok.