Breast Cancer Index Test

Hi Frostecat!

You may find this information from the main Breastcancer.org site's page on Breast Cancer Index Test helpful:

Insurance coverage and financial assistance

The Medicare program and several other major insurance companies have agreed to cover the Breast Cancer Index test.

bioTheranostics, the company that makes the Breast Cancer Index test, has a Patient Advocate Team to help you with verifying insurance coverage and obtaining reimbursement. The company also has a patient assistance program that helps pay for testing. To contact the Patient Advocate Team, call 1-844-319-8111, Monday through Friday, 7 a.m.-4 p.m. Pacific Time. The email address is patientadvocates@biotheranostics.com.

We hope this helps!

--The Mods

At the time I had the test done in 2016 this was the situation - if you had insurance and the BCI test was denied, Biotheranostics would handle appealing to your insurance company. Your oncologist did not have to do anything further, and neither did you as the patient. If your insurance continued to deny, and all appeals yielded no payment, Biotheranostics would absorb the test cost. My theory was that they were building the database to give the test more marketability. If you did not have insurance they also had a patient assistance program with a reduced cost.

frostecat - hey hi!

Boston - this test shows the benefit of remaining on anti-hormonal medication beyond five years with a predictive and prognostic result by looking at 7 genes associated with your original tumor. The BCI Prognostic score estimates how likely the cancer is to come back 5-10 years after diagnosis. Scores range from 0-10. Cancers with scores from 0-5 are considered low risk, and scores from 5.1-10 are considered high risk. The BCI Predictive score looks at the benefit provided by taking anti-hormonals for an additional 5 years.

My result from this test was high risk of recurrence and low benefit from the drugs. This is an unusual result - only about 10% of test results have this arrangement, and my MO requested that I remain on anti-hormonals beyond five years, since low benefit isn't necessarily zero benefit.

Just a warning regarding payment for BCI test. I had mine done in 6/2017. My insurance paid it as out of network. Biotheranostics appealed to my insurance company, but they refused to change billing to in network. I was billed by Biotheranostics for a little over $1200 in 10/2018. They will pro-rate it if you meet strict income guidelines which I did not so I ended up responsible for the bill.

agnes - the OncotypeDX test determines whether there is benefit to adding chemo for breast cancer patients who have estrogen positive (ER+) tumors and assumes use of anti-hormonal drugs in the recurrence score given, while the BCI test determines whether there is benefit to continuing anti-hormonal therapy beyond 5 years. The OncotypeDX test is done at the beginning to help determine treatment decisions, while the BCI test is normally performed after one has been on the anti-hormonal drugs for 5 years. Both are genomic tests, performed on tissue from the surgically excised tumor, but they determine different things using different methodology.

Deleted - wow, I'm really exhausted and confused about which thread I'm in 🙃

Awesome Frostecat - I love MyChart. We know the test results ahead of time and don’t have to wait for the doctor to call. That’s a scary and often long wait.

My Oncotype score was 11. 8% chance of recurrence.

Diane

The test is done at the 5 year point because the purpose is to determine whether to continue anti-hormonal therapy beyond that point. Five years of anti-hormonals is current standard of care, so the assumption of the test is that the patient will complete that therapy time period regardless,as that is what is always recommended at the outset as a minimum. Some patients discontinue taking the medications, or recur while on them, so doing the test prematurely would be an expense that insurance companies would not want to incur.