anyone not get an oncotype test?

I would ritagz...I had the Oncotype test done; my score came back@11. My Oncologist ordered the test(I had never heard of it either) because I had a micromet in my SN. My BS said that would get me chemo which of course I didn't want to do - who does - but my Oncologist wasn't convinced that was the right treatment plan. I was Stage 2, Grade 1. My Oncologist said the test was being used more often than not because she admitted women were being overtreated and the test affords them more information to make the appropriate treatment plan. It is pricey but my insurance BCBS paid for the test. It has to be authorized by your insurance company before your BS will send them the tissue samples. Also, Genomic Labs, the company who performed the test, will work with you on a sliding scale if insurance won't pay for the test. It takes about 10 days to 2 weeks to get the results back. I was a basket case until I got the call from my BS' office. I have to admit I would have a problem with a doctor saying no need for the test but maybe they are under such pressure from insurance companies about over-prescribing the test that they make a judgement call. That wouldn't make me feel warm and fuzzy. No guarantees of course but both my BS and Oncologist have a lot of faith in the test. It also affords me additional information about my particular tumor which was also deemed to be non aggressive. I don't think you can get the test w/o your doctor ordering it but I think if it were me I would press for the test. After all it is your body and your life and your cancer. It is really sad that $ has to play such large role in determining treatment but it does. My BS' office told me BCBS should think about the cost of chemo vs radiation which is dramatic and allow the test whenever possible. BTW I had 33 RADS treatments vs chemo - it was a piece of cake compared to chemo. Good luck and be persistent...we all have to be our own advocates. Diane

dx in December 2013, I had rt. br, gr I, stage I , < 1 cm, DCIS, tubular ca, 2 nodes neg,  her2-, er+/pr+ with lumpectomy and sentinel node dissection with one lymph node also neg... , no oncotype needed as per medical and surgical oncologists. No radiation needed as I am 67, newest studies have shown that women 65 and over who have had no  radiation with similar diagnoses fare almost no different than women who have had radiation . I will start on anastrozole 1mg daily for 5 years.

I have done research and all seems to point out that oncotype is not needed. Part of me wonders what it would have showed, but do not want chemo anyway.  Thought of going to Dana Farber Hospital in Boston for a second opinion but am quite comfortable with my doctors opinions as I am in the neighboring state and my  docs all trained in the Boston area and are highly regarded.  The test is expensive, about $4000 but insurance does pay for it. Sounds as though you need to have a good conversation with your doctor or if you can, try a second opinion. Good luck.

I, did NOT have it....I am Stage 0 Grade 2....no Chemo, no Rads.....A Mastectomy.....I will be 6 years in December....Liz

KNardo

Think you have it right. With a high ki-67g, plus the absence of PR (tends to indicate Luminol , at your young age, your oncologist is likely to feel that chemo is the best treatment option for you, although there is likely to be a tamoxifen or other hormonal follow-up.

But, please know that chemo isn't as bad as you may have heard. Make sure that you discuss drugs that treat side effects, and they work. And we will be here for you.
I should also tell you that on Facebook there is a Young Survival Coalition private group, if you would like to talk to women your age.

With low ER, no PR, and high proliferation, MO likely will strongly recommend chemo. I have been through it twice. Everyone does differently. I tolerated it very well. I exercised the whole time, worked part time, never missed a school event for my kids, and just generally carried on with life. And ..... It is temporary. I considered chemo to be on my side, not the enemy. Cancer was the enemy; chemo was on my team to kick it to the curb. Best wishes on whatever you decide. Sorry you are facing this

KNardo, I too think that with a high ki-67 (meaning the cancer is a fast growing type), grade 3, the absence of PR, LVI, and your young age, your oncologist thinks you need chemo hence there is no need to order an oncotype test. Ki-67 is one of the elements used to calculate oncotype score so it's likely that your oncotype score is going to be high too. My ki-67 is 45%, my oncotype score is 40, putting me in a high risk group. All 4 oncologist I talked to said I need chemo even before the result on the oncotype came back. There are several countries that do not use oncotype score to decide whether or not chemo would be suitable or needed, but the oncologists decide whether or not to do chemo on other factors such as tumor size, grade, nodes involvement, ki-67, etc.

Since your cancer is an aggressive type and you have LVI, you might want to ask your onc if a radiation after a chemotherapy would benefit you. This is what I'm going to ask my onc next time we meet. I didn't know about radiation post MRM until I started reading about LVI. I thought if I had bilateral mastectomy I didn't need radiation.

I was stage Ia/grade 1/ER +/PR+/Her2-/BRAC negative. After lumpectomy (clean margins) and lymph node dissection (negative), my medical ONC told me the that Chemo was not necessary, only radiation. She also stated Onc test would not change her treatment plan for me so it wasn't worth doing (cancer was less than 1cm and caught VERY early). I work in the breast cancer research field and I know she is the best oncologist in the area/have absolute confidence in her plan. With that said, that is totally subjective for each one of us, listen to that little voice--get a second opinion or ask more questions until you are absolutely comfortable with the outcome.

Best of luck!

I was told the same thing sofi. I wondered for some time if I should have insisted but she explained it the very same way to me that there was no way she would give me chemo. I even asked the RO about it and she said the same thing so I guess I have to trust them. I more so wanted to know recurrence score.

I was told that because I am Her2+ that I am not a candidate for the test