Sneak peek at my Oncotype score - opinions, please!

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Emily2008
Emily2008 Member Posts: 605
edited January 2017 in IDC (Invasive Ductal Carcinoma)

I was diagnosed with a new primary (we initially thought it was a recurrence) after 8 years with NED. Happened to log into my patient portal over the weekend and I saw my Oncotype score is 16. Yay, low range! Except...I'm BRCA 2 positive, 44 years old (35 at first DX), luminal B, 1.4 cm tumor, and the second pathologist who read my report at MSKCC put me at grade 2 due to my Ki67 score of 29. I'm wondering what my onc will tell me I should do. I'm definitely doing rads and will have to start an AI, but I fear that due to the other factors, it won't be easy to dismiss the need for chemo again.

I'd love your opinions/stories based on my stats.

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  • lekker
    lekker Member Posts: 594
    edited January 2017

    Sorry you're dealing with another breast cancer. I'm wondering by your avatar if you might be in Philadelphia. If so, Penn has the Basser Center for BRCA - maybe they could give you some advice?


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  • Emily2008
    Emily2008 Member Posts: 605
    edited January 2017

    Actually, I chose the pic because I feel like Rocky -- back in the ring for another fight. But he and Mick have that look in their eyes that says, "We've got this!"

    I'm in Virginia, and actually traveled to Sloan Kettering for another opinion prior to getting my Oncotype results in. Now that I have the score, I'll email the doc I consulted with to get her opinion as well. I was just wondering if others have been in the same boat. Maybe I'll contact the Basser Center. Hadn't heard of them.


    Thanks!

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  • mellee
    mellee Member Posts: 434
    edited January 2017

    The Mammaprint (http://www.agendia.com/healthcare-professionals/br...) could help you make your decision. It isn't always concordant with the Oncotype (it tests totally different biomarkers). So if it comes back low risk, it is one more data point in favor of no chemo. But if it comes back high risk, you may want to consider the chemo based on that plus your pathology.

    The two oncologists I consulted with actually think Mammaprint is the superior test, and it's recently been validated with the MINDACT trial results published in the New England Journal of Medicine in August 2016.

    Insurance may not pay for a second test, but Mammaprint never bills a patient more than $500, and they will even waive that in cases of financial hardship.

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  • KBeee
    KBeee Member Posts: 5,109
    edited January 2017

    Sorry you're dealing with this again. Multiple opinions would definitely help. How did you determine you're luminal B?

    If you list your treatments in your signature, it'll help people commenting know what you've already done

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  • Jackster51
    Jackster51 Member Posts: 357
    edited January 2017

    What chemo did you have already? It's not in your sig line...

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  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited January 2017

    A second primary or a recurrence always seems to require a bit more nuance to me, rather than relying so much on the genetic make up of the tumor. Have a BRCA2 mutation further muddies the waters. I doubt any of us here can offer anything useful other than resources and support.

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  • Emily2008
    Emily2008 Member Posts: 605
    edited January 2017

    Just to update...I finally figured out how to add to my signature line! I established it 8 years ago with my first Dx, so I had forgotten how to do it, lol!

    Onctoype score is low enough that my local MO and the one I consulted at Memorial Sloan Kettering say no to chemo. I start rads in 10 days. As always, when the game plan is in play, I feel more clear-headed.

    Thanks for the support!

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