Oncotype testing with 4 Lymph nodes?
Hi,
It was recently suggested to me by a private pathologist that Oncotype DX now has recommendations for those with 4 to 9 lymph nodes. Is anyone familiar with this new outcome? If you are, is the research strong in its outcomes supporting those with 4 to 9 lymph nodes with recommendations and predictability
Thank You,
Donna
Comments
-
I have no faith in this test at all. I scored a six and now stage IV. Just my opinion
-
DonnaLousie- I'd be interested in this also. My Oncotype score was ordered after my BMX showed 2 sentinel nodes with micromets and prior to my ALND. Had ALND and they found 2 fully positive nodes so I had 4 involved nodes. After the ALND results my MO set up AC/ T
Chemo. Then my Oncotype result came back a 3. He was encouraged by the 3 and changed my chemo regime from AC/T to TC as the heart risk from the A drug he thought outweighed any benefit. He still felt like he had to give me chemo with the 4 nodes and he said in a couple of years we'll see what results are with Oncotype relevance and more than 3 nodes. I'd be very interested to see these recommendations. Can you ask the pathologist where these results are or if they've been published? I did a quick google search and can't find anything. -
- TransATAC Study3: Consistent with NSABP B-14 results for node-negative patients, this study confirmed that the Breast Recurrence Score test provides an improved estimate of risk of distant recurrence for node-positive patients. It found that a low Recurrence Score result was associated with a lower rate of distant recurrence, while a high Recurrence Score result was associated with a higher rate of distant recurrence.
- SWOG 88144: This study determined that the Breast Recurrence Score test is associated with the likelihood of chemotherapy benefit in node-positive patients. A Recurrence Score result <18 predicted little to no benefit from chemotherapy, while a score ≥31 predicted a larger benefit from chemotherapy.
SWOG 8814 Study details4
The SWOG 8814 study analyzed archived tissue from 367 post-menopausal, hormone receptor-positive, node-positive patients with invasive breast cancer treated with tamoxifen or tamoxifen plus cyclophosphamide/doxorubicin/ fluorouracil (CAF).
In the study, the Recurrence Score result was shown to be prognostic for disease-free survival, overall survival, and breast-cancer specific survival in node-positive patients treated with tamoxifen alone as well as predictive of CAF therapy benefit. In addition, the SWOG 8814 study showed that the Recurrence Score result is also predictive of which node-positive patients will likely benefit from the addition of chemotherapy.
The analysis of chemotherapy benefit in disease-free survival by Breast Recurrence Score risk groups showed that only patients with a high Recurrence Score benefitted (p=0.033) and there was no significant benefit in patients in low or intermediate risk groups. See the full study report Results were similar for overall survival and breast-cancer specific survival.TransATAC Study details3
The TransATAC Study further validated that the Recurrence Score result provides the risk of distant recurrence. It was conducted in samples from 1,231 post-menopausal patients with ER+ node-negative and node-positive disease enrolled in the ATAC trial.
Consistent with the NSABP B-14 study results for node-negative patients, the TransATAC study found that the Recurrence Score result was a statistically significant indicator of the risk of distant recurrence in patients with node-negative (p<0.001) or node-positive (p=0.002) disease, treated with either tamoxifen or anastrozole. In a multivariate analysis of node-negative patients that included tumor size, central grade, and age, the Recurrence Score result and tumor size were the only variables that were statistically significant in predicting time to distant recurrence (p<0.001). In addition, it was found that the 9-year risk of distant recurrence increases with the number of positive nodes for all Recurrence Score values. For patients with low Recurrence Score results and 1-3 positive nodes, the 9-year risk of distant recurrence was similar to that of patients with node-negative disease. See the full study report
-
-
This is from 2015.
"The Oncotype DX test has been validated for lymph node positive estrogen receptor-positive patients with a maximum of three positive lymph nodes."
-
Who Might Benefit from the Oncotype DX Breast Cancer Assay?
The Oncotype DX breast cancer assay can be used by all patients newly diagnosed with early stage, invasive breast cancer who are:
- Node-negative or node-positive (cancer has spread to no more than 3 lymph nodes)
- Oestrogen receptor (ER) positive and
- Human epidermal growth factor receptor 2 (HER2) negative
https://www.stabiopharma.com/index.php?q=oncotype-dx-breast-recurrence-score.html
-
Other genomic tests
There are other genomics tests used to analyze breast cancer tumors. To learn more, click on the links below.
- The Breast Cancer Index test is used to predict the risk of node-negative, hormone-receptor-positive breast cancer coming back 5 to 10 years after diagnosis.
- The EndoPredict test is used to predict the risk of distant recurrence of early-stage, hormone-receptor-positive, HER2-negative breast cancer that is either node-negative or has up to three positive lymph nodes.
- The MammaPrint test is used to predict the risk of recurrence within 10 years after diagnosis of stage I or stage II breast cancer that is hormone-receptor-positive or hormone-receptor-negative.
- The Mammostrat test is used to predict the risk of recurrence of early-stage, hormone-receptor-positive breast cancer.
- The Prosigna Breast Cancer Prognostic Gene Signature Assay (formerly called the PAM50 test) is used to predict the risk of distant recurrence for postmenopausal women within 10 years of diagnosis of early-stage, hormone-receptor-positive disease with up to three positive lymph nodes after 5 years of hormonal therapy.
http://www.breastcancer.org/symptoms/testing/types/oncotype_dx
-
Sample Report for (hypothetical) case with 4 or more positive nodes.
https://www.stabiopharma.com/assets/files/r-oncotype-breast-sample4nodespositive.pdf
-
See page 8 here.
This item is from 2017.
-
Thank you for all the information. The pathologist did sight a research study with node positive women but I can not recall the last name. I will follow up with the group and provide the authors name. It has challenging as I am on the fence with 4 nodes and onco score of 17. It seems like this intermediate to low group like myself does not have a strong evidence as other groups.
-
hi Donna Louise. I had 1/3 nodes positive, and was oncotype 19. I wrestled with the chemo question for about a week and then decided to do chemo. Once you make your decision either way you'll probably feel better--at least I did. Sending you strength - you'll figure it out and you will feel better
-
Hello Group,
Thank you for all of your replies. Here are two studies the pathologist provided me that I wanted to share. I have not had a chance to read these two studies but here they are:
Loncaster et al. 2017. Impact of Oncotype DX breast recurrence score testing on adjuvant chemotherapy use in early breast cancer. Eur J Surg Oncol, 43: 931-937.
Roberts MC et al. 2017. Breast cancer specific survival in patients with lymph node-positive invasive breast cancer and Oncotype DX recurrence score results in the SEER database. Breast Cancer Res. Treatment, 163: 303-310.
Thank You,
Donn
Categories
- All Categories
- 679 Advocacy and Fund-Raising
- 289 Advocacy
- 68 I've Donated to Breastcancer.org in honor of....
- Test
- 322 Walks, Runs and Fundraising Events for Breastcancer.org
- 5.6K Community Connections
- 282 Middle Age 40-60(ish) Years Old With Breast Cancer
- 53 Australians and New Zealanders Affected by Breast Cancer
- 208 Black Women or Men With Breast Cancer
- 684 Canadians Affected by Breast Cancer
- 1.5K Caring for Someone with Breast cancer
- 455 Caring for Someone with Stage IV or Mets
- 260 High Risk of Recurrence or Second Breast Cancer
- 22 International, Non-English Speakers With Breast Cancer
- 16 Latinas/Hispanics With Breast Cancer
- 189 LGBTQA+ With Breast Cancer
- 152 May Their Memory Live On
- 85 Member Matchup & Virtual Support Meetups
- 375 Members by Location
- 291 Older Than 60 Years Old With Breast Cancer
- 177 Singles With Breast Cancer
- 869 Young With Breast Cancer
- 50.4K Connecting With Others Who Have a Similar Diagnosis
- 204 Breast Cancer with Another Diagnosis or Comorbidity
- 4K DCIS (Ductal Carcinoma In Situ)
- 79 DCIS plus HER2-positive Microinvasion
- 529 Genetic Testing
- 2.2K HER2+ (Positive) Breast Cancer
- 1.5K IBC (Inflammatory Breast Cancer)
- 3.4K IDC (Invasive Ductal Carcinoma)
- 1.5K ILC (Invasive Lobular Carcinoma)
- 999 Just Diagnosed With a Recurrence or Metastasis
- 652 LCIS (Lobular Carcinoma In Situ)
- 193 Less Common Types of Breast Cancer
- 252 Male Breast Cancer
- 86 Mixed Type Breast Cancer
- 3.1K Not Diagnosed With a Recurrence or Metastases but Concerned
- 189 Palliative Therapy/Hospice Care
- 488 Second or Third Breast Cancer
- 1.2K Stage I Breast Cancer
- 313 Stage II Breast Cancer
- 3.8K Stage III Breast Cancer
- 2.5K Triple-Negative Breast Cancer
- 13.1K Day-to-Day Matters
- 132 All things COVID-19 or coronavirus
- 87 BCO Free-Cycle: Give or Trade Items Related to Breast Cancer
- 5.9K Clinical Trials, Research News, Podcasts, and Study Results
- 86 Coping with Holidays, Special Days and Anniversaries
- 828 Employment, Insurance, and Other Financial Issues
- 101 Family and Family Planning Matters
- Family Issues for Those Who Have Breast Cancer
- 26 Furry friends
- 1.8K Humor and Games
- 1.6K Mental Health: Because Cancer Doesn't Just Affect Your Breasts
- 706 Recipe Swap for Healthy Living
- 704 Recommend Your Resources
- 171 Sex & Relationship Matters
- 9 The Political Corner
- 874 Working on Your Fitness
- 4.5K Moving On & Finding Inspiration After Breast Cancer
- 394 Bonded by Breast Cancer
- 3.1K Life After Breast Cancer
- 806 Prayers and Spiritual Support
- 285 Who or What Inspires You?
- 28.7K Not Diagnosed But Concerned
- 1K Benign Breast Conditions
- 2.3K High Risk for Breast Cancer
- 18K Not Diagnosed But Worried
- 7.4K Waiting for Test Results
- 603 Site News and Announcements
- 560 Comments, Suggestions, Feature Requests
- 39 Mod Announcements, Breastcancer.org News, Blog Entries, Podcasts
- 4 Survey, Interview and Participant Requests: Need your Help!
- 61.9K Tests, Treatments & Side Effects
- 586 Alternative Medicine
- 255 Bone Health and Bone Loss
- 11.4K Breast Reconstruction
- 7.9K Chemotherapy - Before, During, and After
- 2.7K Complementary and Holistic Medicine and Treatment
- 775 Diagnosed and Waiting for Test Results
- 7.8K Hormonal Therapy - Before, During, and After
- 50 Immunotherapy - Before, During, and After
- 7.4K Just Diagnosed
- 1.4K Living Without Reconstruction After a Mastectomy
- 5.2K Lymphedema
- 3.6K Managing Side Effects of Breast Cancer and Its Treatment
- 591 Pain
- 3.9K Radiation Therapy - Before, During, and After
- 8.4K Surgery - Before, During, and After
- 109 Welcome to Breastcancer.org
- 98 Acknowledging and honoring our Community
- 11 Info & Resources for New Patients & Members From the Team