Those with HR Positive Tumors and Low Oncotype DX Scores....
Would you mind sharing what your percentage of ER/PR was? I'm trying to determine is high (greater than 90%) hormone expression equates to a lower Oncotype score. Thanks!
Comments
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It usually does. The higher ER/PR positive usually means a lower score. My ER on biopsy was 96 per cent and PR 78 per cent. My Oncotype results showed even higher percentages based on my post surgical sample and my Oncotype was a 3. The higher ER positive you are the more you will respond to Tamoxofen and AI's and less responsive to chemo so yes there is a correlation. Its basically showing what is feeding your cancer.
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I've been doing some research, and that's what I've found, too. My ER was 93% and my PR was 91% on biopsy, so I'm hoping for a low OncoType score(should find out in a couple of weeks).
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My understanding is that there are correlations but the whole point of the oncotype test is that it delivers something beyond what the hormone percentages can.
Based on all the rest of my statistics, my doctor was expecting a low oncotype score and I got a 9. She said that was "concordant", so she felt comfortable putting me in a relatively lower risk group (so I am taking tamoxifen instead of AI+OS). But results *can* be 'discordant', and they want to make sure they catch those cases - where a small low grade hormone positive tumor could still benefit from chemo because the oncotype is high, or where a larger, high grade tumor comes back with a low oncotype score and chemo could do more harm than good, and they want to know that too.
So I would say that a higher hormone percentage might correlate to lower oncotype scores, but it definitely wouldn't *equate* to them.
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My Oncotype score was 3. My ER was 100% and my PR was 99.89%. KI67 was 3.3. My understanding is that a lower PR% and a higher Ki67 will drive the Onco score up a bit. My sister's Onco score was 17 and her ER was 90%, PR was 14% and her KI67 was 15.9.
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My ER and PR were both upper 90s, I think 99 and 97. My oncotype was 17, just on the upper edge of low. But I also had a micromet in the sentinal node - so hormone numbers aren't the only thing considered on the oncotype.
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Genomic Health will answer questions like this. It is pretty complicated.
I had a grade 3 tumor and highish ki67% but Oncoty[pe of 8. My estrogen score was 95% and progesterone 80 as I remember.
I had LVI which isn't taken into account with the Oncotype but certainly raises risk.
I had mastectomies, and do Femara, not chemo and no radiation.
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My tumor was 98%ER & 95%PR, grade 2. High ki67 of 67%. Oncotype 20. So there's no correlation for me. But no doubt the high ki67 factored into the intermediate oncotype score.
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I did not have Oncotype Dx testing, opted for MammaPrint Dx. I was 95% ER+ and 95% PR+ with HER- yet, my recurrence rate was at 29% with hormonal therapy. My path report did not include Ki67% score. That could have been a contributing factor. My tumor was 2.2, with no lymph involvement but did detect a single tumor cell. Another factor, I'm assuming contributing to recurrence score.
My MO highly recommended chemotherapy. I asked for a 2nd opinion with the best cancer research institution in the Netherlands, Antoni van Leeuwenhoek hospital and the specialist concurred that chemotherapy would be beneficial.
From what I’ve read, my BC subtype should have been enough with hormonal therapy, but genomic testing indicated otherwise. Chemotherapy is no joy ride, but I want to do everything to help lower my recurrence percentage.
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My path report did not include a Ki67% either. I thought that was strange. What I’ve read indicates that if ER and PR are both high(over 90%), and the mitotic score was 1(low), it usualy(but not always) means a lower recurrence score
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My Er/ Pr were in the nineties. Grade 2, ki-67 22%, Oncotypedx 3, so potentially discordant results. My doc puts little faith in ki-67. It was nice to have the Er Pr percentages backed up by Oncotypedx peeps (they show their calculated Er Pr).
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Ki67% is only one of several proliferative factors in the Oncotype test.
My mitotic score was high but Oncotype was low. I always wonder if sometimes a low score just means chemo wouldn't work. Four years out so so far okay.
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It gives a double result where chemo would be effective and a recurrence probability could be mutually exclusive. Not sure I put alot of value in oncodx but that is one of the few evaluation tools we have.
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Last time around, my ER was 90%, PR was 0% and my oncotype was 39.
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Does anyone know if LVI is taken into consideration when determining Oncotype scoring? I had a small, microscopic focus suspicious of LVI and I'm wondering if that would drive my score up.(should find out score in one week). Thanks!
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kec1972- no it wouldn't effect the Oncotype score either way. That is not a factor in determining Oncotype recurrence score.
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Most people I read about have a high ER percent if they are ER positive. My ER was 40% and my PR was 90%. My oncotype score was 17. No chemo, just radiation and Tamoxifen.
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Thanks to all who replied! Would anyone else like to chime in on this topic
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100% ER+;. Oncotype 12; 2.5 cm, micrometer
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95% er 0% pr oncodx 34, 2 tumors each 1cm one idc and one ilc.
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I finally got my Oncotype result on Friday and all I know is it was a 7, which is low risk, but no mention of biomarkers such as Ki67. I have an appointment with RO on Wed to go over the test in detail. BS thinks it's likely I can avoid radiation so I'm hopeful. Will still need to see MO since 95% ER+/PR+ but one step at a time.
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Yogamom, what grade was your cancer? That's great that you have such a low Oncotype. Im meeting with MO today to find out my results of that test. Hoping it's low like yours. I was 93% ER positive and 91% PR positive with a low mitotic score, so I'm hopeful. Did your BS say why you might be able to avoid radiation? I'm thinking of declining it myself since it does nothing to improve overall survival.
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My understanding is that there is no avoiding radiation with a lumpectomy, unless you are over 75 years old and low risk.
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Just spent 2 hours with RO and it seems she's not as comfortable w/ no rads as BS was. Since that's her specialty shouldn't be surprised. She uses the Sloan Kettering breast cancer nomogram to assess risk and my risk number was 13 (13% chance of recurrence over 10 yrs), the golden number with that is under 10. My BS was sure she'd be comfortable with Oncotype DX of 7, which is really low. Can't find any comparison on which score may be most reliable, has anyone here had a similar experience?
I'll give my BS a call and see if she sticks with her original suggestion. It's still 87% likely they'll be no recurrence, 93% if you go with Oncotype. Wish my hospital had a tumor board so I could get multiple opinions but only one tx recommendation. Thoughts/ suggestions appreciated. Thanks.
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Mine was IDC stage I grade 1 tubular carcinoma. 1.4 cm. Ki67 5% ER 100% PR 80% Oncotoype score 5. Tamoxifen for 5 years. Other than ovarian cysts - side effects are minimal so far going on 3 months.
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Nicetomichu, I have never heard of Stage 1C Breast Cancer. Is that part of the new staging released last year? interesting. I am Stage 1B due to micromets in my first sentinel node.
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Does the oncotype score have anything to do with radiation decisions for some cancers? My understanding was the choices were mastectomy OR lumpectomy + radiation. The oncotype was strictly to determine if chemo would be necessary, or even effective.
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Alicebastable I think I read someone with a tumor under 1cm, no nodes and a low Oncotype having a lumpectomy with no radiation. I think it is pretty standard to do radiation with a lumpectomy and Oncotype is used more to determine if you would benefit from having chemotherapy too.
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ALice, my choice was mastectomy OR lumpectomy plus radiation. My tumor was barely 1cm, node negative. Oncotype score 21. I chose no chemo as it would have given me marginal benefit at best. Oncotype is just used to estimate chemo benefit(if any). I believe that sometimes DCIS, in certain cases, can be cured with a lumpectomy and doesn't necessarily need radiation. I've never heard that with invasive tumors, though.
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ER 99% PR 90% Oncotype 4
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