Oncotype Test Score of 5

Ruby3813
Ruby3813 Member Posts: 96
edited July 2017 in Stage I Breast Cancer

First off, I'm EXTREMELY happy with my score, but until I meet with my RO and MO next week, I guess I won't know for sure if they'll recommend chemo. My BS doesn't think they will, but there's that underlying worry. If you were a betting woman (or man), what's your opinion? Don't worry about "diagnosing" me or me thinking I'm hanging my hat on what you tell me...lol. Just looking for opinions. :-)

Thanks!

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Comments

  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited March 2017

    With your small, ER+PR+HER-, low-aggressive, Oncotype 5 cancer I would be MAJORLY surprised if the suggest chemo. In fact, if they do, you should RUN, not walk, and find another MO. If I were a betting woman, I would bet the whole farm on this one.

  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited March 2017

    I agree with mustlovepoodles. Chemo would be inappropriate for you. Look at my signature. I didn't have chemo.

  • DK21
    DK21 Member Posts: 4
    edited March 2017

    Ruby3813 -may I ask how old you are?

  • Ruby3813
    Ruby3813 Member Posts: 96
    edited March 2017

    Thanks, mustlovepoodles and SummerAngel. That's what I'm thinking and hoping for too, although like I said, my BS feels the same way. I guess I just needed some reassurance from the "real" professionals here. :-)

    DK21 - I turned 65 in November.

  • tgtg
    tgtg Member Posts: 266
    edited March 2017

    Ruby--

    My Oncotype number was 12 (with a slightly larger tumor size than yours), and the MO said there would be absolutely no benefit from chemo--just risk from it. I was 71 at diagnosis. My best advice o you--take one day at a time, and don't anticipate problems--there's no need to create stress, which always, even without bc, is detrimental to health of body and mind.


  • Ruby3813
    Ruby3813 Member Posts: 96
    edited March 2017

    Thanks tgtg! Makes sense to me!


  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited March 2017

    I'll bet the farm on no chemo as well!

  • Jezikah
    Jezikah Member Posts: 93
    edited March 2017

    Before we found out my second tumor was HER2+, I had an oncotype test done with the biopsy tissue of the larger tumor. It was a 20 and my MO recommended no chemo based on that... said the statistical decrease in recurrence would be minimal and wouldn't be worth the side effects. With ER+/PR+ cancers, the larger benefit is from the hormonal therapy.

  • Emily2008
    Emily2008 Member Posts: 605
    edited March 2017

    I'm betting no way to chemo!

  • Ruby3813
    Ruby3813 Member Posts: 96
    edited March 2017

    Thanks Ladies! Yes, from what I've read, the side effects aren't worth the small decrease in recurrence benefit.

    I got my appt with the MO changed, so I go see him on the 17th now. Fingers crossed! :-)

  • Meow13
    Meow13 Member Posts: 4,859
    edited March 2017

    I have oncodx number envy.

  • Ruby3813
    Ruby3813 Member Posts: 96
    edited March 2017

    Awwww, I'm sorry, Meow13. I didn't mean to hurt your feelings. Keep studying and maybe you can get a good score too! Happy

    Just kidding, of course. BC is nothing to joke about, but hey, we have to laugh about something!

    Have a great weekend!

  • Dianarose
    Dianarose Member Posts: 2,407
    edited March 2017

    I scored a 6 , still did chemo after theyfound more cancer. Now stage IV and doing more chemo. All a crap shot.

  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited March 2017

    It certainly is Dianarose. My onc has said all all along not to put too much faith in one number. Sorry about the mets. Thanks for your post.

  • Dianarose
    Dianarose Member Posts: 2,407
    edited March 2017

    Farmerlucy- love the name 😎If I knew what I know today 18 years ago the boobs and ovaries would have gone the day my last child was born. Both a curse to women

  • Meow13
    Meow13 Member Posts: 4,859
    edited March 2017

    I wasn't offended happy you got a score of 5. But I do envy your score mine was 34. It has been 5 years NED and I didn't do the recommended chemo just AI.

    I have to laugh because it does feel like a failed test grade, its just a number.

  • Ruby3813
    Ruby3813 Member Posts: 96
    edited March 2017

    I'm sorry, Meow13. I'll keep you in my prayers. (((Hugs)))

  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited March 2017

    Dianarose, you say you had a 6 but your signature line says you had bilateral cancer. Did you get the other side tested?

  • msrbshil
    msrbshil Member Posts: 1
    edited March 2017

    I scored 17 and didn't have Chemo. I am doing an AI and feel pretty ood.

  • Ruby3813
    Ruby3813 Member Posts: 96
    edited March 2017

    Thanks Msrbshil - thanks! That's encouraging!

  • Professor50
    Professor50 Member Posts: 220
    edited March 2017

    We're oncotype score twins! :) No chemo. I have been on tamoxifen (or some other hormonal therapy) for almost three years. As you can see, I had a lumpectomy and rads and that is that.... Good luck!

  • Dianarose
    Dianarose Member Posts: 2,407
    edited March 2017

    SummerAngel- they did the test after I had a lumpectomy (second round) at which Tim I had 4 positive nodes which still fit in the guidelines. Came back a 6 foe effective on chemo and an 8 for recurrence. Then I did the mastectomy because they did not get clean margins. The rest went downhill from there. This is my third round and I had a surgeon go in my tummy to get samples of cancerous tissue to do the chemo sensitivity test so we know which chemos will work and which ones won't

  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited March 2017

    Dianarose, I'm confused by your response. They did the Oncotype test on one side? Or did they do the test on both sides? I'm wondering because your signature line says, "ILC, Both breasts".

  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited March 2017

    Ruby, I have a saying that the live by: Ya can't cry all the time. Laughter is medicine. the day I can't appreciate a little twisted humor is a dark day indeed.

  • Dianarose
    Dianarose Member Posts: 2,407
    edited March 2017

    Summer- the first lumpectomy was 2004 and I don't think they did them then. The second time was to the other breast and that's the one the did it on. When they did the mastectomy the original breast that has been radiates had no cancer. Wish now they had zapped them b

  • Ruby3813
    Ruby3813 Member Posts: 96
    edited March 2017

    Thanks Professor and Poodles! I should find out this Friday. :-)

  • SummerAngel
    SummerAngel Member Posts: 1,006
    edited March 2017

    Thanks, Dianarose. I ask because there was a study about bilateral cancer and Oncotype, and there definitely can be large variations between tumors. So, although your second cancer scored a 6, your first may have been high risk and could have been the cause of your progression. Oncotype has been shown to be an accurate predictor of risk, but all factors need to be taken into account. It's not a 'crap shoot', it's statistics. Statistically, a person with an Oncotype of 5 (and no other tumors) has a very low risk of recurrence and statistically that person has a greater risk of harm than benefit with chemotherapy.

  • Dianarose
    Dianarose Member Posts: 2,407
    edited March 2017

    summer angel- I think they keep learning new things all the time. I agree if chemo is not going to benefit you don't put your body through it. I have been doing chemo since beginning of November and I am so tired of it. I know how it is going to make me feel even what day. Not fun. I wish you all the best and hope you stay cancer free always

  • Kimhf
    Kimhf Member Posts: 15
    edited July 2017

    Hi: I have a question regarding Staging and Oncotype score. I was recently diagnosed. I had my surgery - I caught it early. Tumor wasn't a lump, just a collection of cells 1/2 inch long. Clean margins. Nothing in the nodes. I've been diagnosed as Stage 1. I have not gotten in to see an oncologist yet so I'm stressing about the Oncotype score. Is the Oncotype score usually concurrent with the Stage? In other words, if I'm Stage 1, should my Oncotype score be low? I don't know how it works. Thanks.

  • BarredOwl
    BarredOwl Member Posts: 2,433
    edited July 2017

    Hi Kimhf:

    No, Oncotype Recurrence Score cannot be predicted with accuracy based on stage information.

    The Recurrence Score reflects aspects of tumor biology. It is calculated from the mRNA levels (which reflects expression or how actively the genes are being used) of 16 cancer-related genes in a tumor sample (and 5 control genes).

    By the way, you should get complete copies of your pathology reports from all surgeries and biopsies.

    From another post, you have both DCIS and "Stage I" invasive breast cancer.

    DCIS is "non-invasive" by the pathologist's assessment, meaning it appears to be confined to the inside of the ducts. Therefore, its shape follows the branching pattern of the ducts it is located in.

    In contrast, any invasive or infiltrating breast cancer (microinvasive or larger) is deemed "invasive" by the pathologist, because it has broken through the wall of the duct to "invade" and grow in the tissue surrounding the duct. The invasive breast cancer forms a "tumor" or ball of cells. Sometimes, there is more than one invasive tumor.

    You need to obtain copies of the pathology reports from all surgeries and biopsies to confirm and understand your diagnosis.

    Your pathology reports should list the features of the DCIS and invasive breast cancer separately.

    DCIS: The pathologist typically reports the extent or size of the DCIS in largest dimension; grade; estrogen receptor ("ER") status; progesterone receptor ("PR") status; and surgical margins (smallest distance from DCIS to edge of tissue removed).

    Invasive Breast Cancer: The pathologist typically reports the histology (e.g., ductal, lobular, other); invasive tumor size; lymph node status; ER status, PR status, and HER2 status. Additional features that may affect treatment advice include grade and lymphovascular invasion. Sometimes, additional markers, such as Ki-67 protein may be reported. The surgical margins for the invasive disease should be separately reported.

    OncotypeDX test for invasive disease: This test is used for certain cases of hormone receptor-positive, HER2-negative invasive breast cancer, and assumes receipt of endocrine therapy. Typically (though not always) the test is used when the Tumor is greater than 0.5 cm in largest dimension. The test is most common in node-negative disease, but is sometimes considered in patients with 1 to 3 positive nodes. It is used in those for whom chemotherapy would otherwise be considered or recommended under guidelines, based on standard clinical (e.g., age and co-morbidities) and pathologic criteria (e.g., histology, invasive tumor size, nodal status, ER, PR and HER2 status). The results are used to help decide whether a patient should receive a recommendation for chemotherapy plus endocrine (anti-hormonal) therapy OR endocrine therapy alone. The use and interpretation of the test results is within the area of expertise of Medical Oncologists.

    BarredOwl

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