Did anybody do oncotype dx with one 3mm positive node ?

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cathy67
cathy67 Member Posts: 514
edited May 2020 in Diagnosed and Waiting for Test Results

My pathology report back as 1/1 sentinel node, with 3mm deposit. I know, if under 2mm, then make sense to try oncotype dx. I am 52 years, strong ER positive and HER2 negative, grade 2. I am in BC Canada, BC's insurance can only cover under 2mm and only one positive. But I searched, and found positive node can be up to 3. One women said, with 2 positive nodes she got very low score.

I just wonder if my situation will make sense to try oncotype dx? In other word, shall I do chemo no matter what score will return, I am already 50 years, that is why I ask.

Thanks.

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  • ctmbsikia
    ctmbsikia Member Posts: 1,095
    edited October 2019

    I had a micro met of 3mm positive sentinel node. The 2nd one pulled was negative. I had the oncotype test. The actual test results say for 1 to 3 positive nodes. My score was a 17, I'm also hormone positive so no chemo, just radiation and the hormone therapy.


    I say get the test if you can. You are definitely a candidate for it. (At least in the US you would be) Good luck!

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  • Brilee76
    Brilee76 Member Posts: 227
    edited October 2019

    These are the notes from pathology on my nodes:


    DIAGNOSIS
    A. LEFT AXILLARY SENTINEL LYMPH NODES, EXCISION:
    - FEATURES CONSISTENT WITH MICROMETASTATIC CARCINOMA IN ONE OF THREE
    LYMPH NODES, TUMOR FOCUS MEASURES 0.26 MM (SEE COMMENT).
    - NEGATIVE FOR EXTRANODAL EXTENSION.


    COMMENT
    In specimen A from the focus determined to be a micrometastasis, the
    cytokeratin positive cells are identified on the immunostain slide and
    one of the H&E levels; however, it is in a detached subcapsular
    area limiting assessment for a true micrometastatic focus. Recommend
    correlate with other clinical findings in the assessment of using this
    finding in planning treatment.


    I had a test similar to oncotype performed. I was looking for the paperwork my oncologist gave me for the name of the test but it must be at home with my other paperwork. That test came back showing a 28% chance of recurrence and chemo would reduce that chance by 13%. My oncologist felt it was worth the risk to do chemo since I am only 43. I wonder if there is a test similar to oncotype that would be covered for you. I'll revisit this post if I find my paperwork with the name of the test my oncologist used.

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  • cathy67
    cathy67 Member Posts: 514
    edited October 2019

    Thank you, two lovely ladies.

    I don't know how much it cost, it sounds $4000. I will ask MO this tomorrow. But I am thinking that, if he prescribes very light dose, maybe I just take it.The oncotype dx test takes one month to get back.

    It is so bad, just 1mm kicks me out of the coverage.

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  • cathy67
    cathy67 Member Posts: 514
    edited October 2019

    Just back from first MO appointment.

    I asked him, if no insurance issue, will you recommend me to go for that test? He said, 100%. Before that, he recommended ACT regimen 2 weeks 8 does, I asked why so heavy, he said, light dose does not work. Then, I asked this test. I spent CAD 4200, cheaper than I thought, I guess it is USD 4000.

    I will have CT Scan, MO said, he thinks I only have 2 percent to be positive, hopefully I am in the 98 percent group.

    Thanks again ladies.

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  • cathy67
    cathy67 Member Posts: 514
    edited November 2019

    Hi,

    I got my oncotype score finally last week, and it is 6! Of course, no chemo, I just want to tell ladies, if you are qualified for the test technically, just not covered by insurance, please do it, no matter what the result will be, either yes or no for the chemo, it gives you peace of mind.

    Thanks this community! And best wishes for all the oncotype tests, I know waiting is dreadful.

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  • edwards750
    edwards750 Member Posts: 3,761
    edited November 2019

    Congrats on your score Cathy and I agree definitel have the test. My insurance paid for mine which was $5k in 2011. I would have found a way if they hadn’t although Genomic Labs who conducts the test said if insurance wouldn’t pay they would do a sliding scale.

    My score was 11. It allowed me to dodge chemo thankfully. 8 years out last August.

    Diane

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  • cathy67
    cathy67 Member Posts: 514
    edited November 2019

    Hi edwards750,

    I wish I will have 8 and more years as well!! Let's count together.

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  • edwards750
    edwards750 Member Posts: 3,761
    edited November 2019

    Will do Cathy! Every year that goes by without a recurrence is very encouraging. My MO said most incoming it’s use 5 years as a milestone.

    Keep the faith you’ll get there!

    Diane

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  • Meow13
    Meow13 Member Posts: 4,859
    edited November 2019

    My score was 34 and I didn't do chemo, I didn't have any positive nodes but I was 95% er positive and 0% pr, so negative. I am 8 years out no recurrence.

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  • cathy67
    cathy67 Member Posts: 514
    edited November 2019

    Hi edwards 750,

    Today I went for a CT Scan, my lifetime first one, very scared of that!

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  • rubypenguin
    rubypenguin Member Posts: 8
    edited May 2020

    You give me hope! I am 70 (nearly 71) . I was diagnosed in February with a small tumor,, found by accident (my right breast had calcifications, and I was usually called back every other or every two years for diagnostic mammogram and sonogram after 3D screening. The radiologist ordered a biopsy of an area of calcifications that turned out benign, but saw during the biopsy the small tumor - didn't appear on any imaging - including MRI with contrast dye before surgery). I had a mastectomy in late March, and received my Oncotype score (32) in late April. (Yes, there was a delay in Genomics Lab recording the sample as "received" and then processing it.. The hospital pathology lab had to give them specifics about when received and by whom before they finally logged it in!). The results were surprising - I had 7 lymph nodes removed and all were clear.

    The major problem I have is the discrepancies between the ER and PR scores on the Onco and the pathology - path: ER positive (99%), PR positive (60%) but Onca said I was barely ER positive and I was significantly PR negative. In a forum on discrepancies, folks referenced you as having foregone the decision to have chemo - one I'm seriously considering, given my age and the situation we currently find ourselves in.

    Glad you are doing well!

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  • cathy67
    cathy67 Member Posts: 514
    edited May 2020

    Hi rubypenguin,

    Sorry that you had to come here, this is the forum that nobody wanted to join, but had to, then found so warm here. Oh, your surgery was in late March, luckily not delayed due to covid-19. Now I am waiting for my first routine after treatment, don't know when I can go for that, lots of normal hospital services were stopped, now gradually reopening.

    I read lots of women said, PR and ER on oncotype report are different from the pathology report after surgery, but oncotype is world's no. 1 test to evaluate the chemo benefit and provide more accurate info for further treatment, all doctors recommended it. My radiation oncologist was willing to share something with me, he said, they discussed my case in their group meeting, cause the oncotype test changed the previous treatment suggestion. And I know similar situation also happens on other women. I said to my friend, no matter yes or no to chemo, I must know why. The pathology report is not enough, I encourage women ask for this, doctors won't mention that if it is out of insurance scope.

    I wish you a quick recovery. Let's count together, one year, two years.....




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