OncotypeDX ca Breast Cancer Index BCI

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Hi.

I am curious how different your risk results have been for those that have had both the oncotype and BCI? Thank you!

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  • Peregrinelady
    Peregrinelady Member Posts: 1,019
    edited November 2019
    I had a low Oncotype (12) but a high risk result on the BCI. Fortunately, it also said high benefit from continued use of antihormonals.
  • Garnersuz77
    Garnersuz77 Member Posts: 44
    edited November 2019
  • Kath1228
    Kath1228 Member Posts: 76
    edited November 2019

    My Oncotype was low (11) and my BCI came back just barely in the high risk range at 5.2 (anything over 5.0 is high risk) but I came back as low benefit of continued hormonal therapy. I just finished 5 years of letrozole, but plan to continue for up to 10 years if I can....

  • Falconer
    Falconer Member Posts: 1,192
    edited November 2019

    Is the BCI test done on the original tumor? What is used to determine your BCI?

  • Peregrinelady
    Peregrinelady Member Posts: 1,019
    edited November 2019
    Yes, it is done on the original tumor. I am not sure why more drs. do not use it in determining whether or not to continue on the antihormonals. My onco erroneously ordered the test for me shortly after diagnosis. It shouldn’t be done until you are close to five years on the drugs. However, my high result gave me incentive to get through any side effects and to not skip any doses.
  • MegOh
    MegOh Member Posts: 12
    edited November 2019

    Hi Ladies,


    I just got my onco score back - 24. I'm 49 1/2 so in between the two charts. In my head 25 and below is low risk of recoccurence.

    I am going to do radiation and plan on doing Tamoxifen for 10 years.

    My oncologist is trying to make a chemo appt for me this Thursday w/out even speaking to me first (and I haven't seen the report)

    Thoughts from those who have been there? :)


    Thanks!


  • Karen2019
    Karen2019 Member Posts: 98
    edited November 2019

    Meg -

    First off, WTF is with your oncologist making you a chemo appointment without even speaking with you??? That is just wrong. Particularly with a score of 24 at your age. While you are on the high end of low risk, you are definitely not in the "must have chemo" area. To me, you are 100% in the gray, "it's really up to you" zone, where your score is on the fence and it comes down to taking a good look at your own feelings about it, adding in the other factors of your life which would be affected, and making a considered decision. Your MO should be bringing you in and talking it out, not making the decision for you.

  • Garnersuz77
    Garnersuz77 Member Posts: 44
    edited November 2019

    Hi Meg-

    I agree with Karen that you are in a grey area that deserves careful consideration for chemo. I have a girlfriend with very similar dx details. Her Oncotype was also in the middle grey zone and so had an additional test the MammaPrint to help her make an informed chemo decision. The MammaPrint doesn't have a middle zone you're either low or high risk. In her case she was high risk which obviously wasn't what she was hoping for but it did give her peace of mind that chemo was the right choice and likely to have big benefits for her. Hugs.

  • jojo9999
    jojo9999 Member Posts: 202
    edited November 2019

    I just read this post and then found this abstract. I haven't read it fully and not sure I will understand it all when I do, but the researchers are comparing Oncotype DX and BCI.

    Stratification of oncotype (ODX) Recurrence Score (RS) by Breast Cancer Index (BCI) and its relation to discordance.

    https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.15_suppl.e12025

  • Falconer
    Falconer Member Posts: 1,192
    edited November 2019

    Thanks Peregrine, fromFalconer.

  • Wereflyn
    Wereflyn Member Posts: 37
    edited December 2019

    Megoh

    I went through something similar. The cancer center I have been going to sees things totally different. In my case I was initially told I only had a small tumor in my left breast and the MRI indicated my lymph nodes were clear. I am post menopausal and after my bilateral mastectomies I would consider taking tamoxifen.

    All of that changed 4 days after my surgery.... the tumor in my breast was 11mm and had clear margins. They found a 7mm tumor in the sentinel node that did NOT have clear margins and the other 2 nodes were clear. The treatment plan was established without explaining the Oncotype DX results to me. 16 chemo treatments/ 33 radiation treatments and 10 years on hormone therapy.

    During my chemo counseling session I asked the NP for my Oncotype test results and they were just handed to me. To my surprise it was a 15/100...My MO insists that the “protocol" is what was prescribed above and since it was in my nodes they always do chemo.

    It happened that someone at church didn't need chemo and she had more lymph node involvement. Her score was 25/100. Why.....because she is 72 and I'm 58. But she had radiation and hormone therapy.

    I do not regret doing the chemo because I know I have done everything I could do for it not to come back. This is just another point of view. Do what you think is best for you and your family.

  • Scrafgal
    Scrafgal Member Posts: 631
    edited December 2019

    Megoh

    If you are dead set against chemo, I get it...who wants chemo anyway? and certainly your MO should respect your wishes.

    However, did you investigate recent findings about risk stratification for women 50 and younger.? For node negative women, I believe a score of 21 to 25 is medium risk where chemo benefits are likely higher than the risk. I don't know the similar risk for node positive situations but it would be worth asking about, if you are open to chemo.

    I was diagnosed at 50...still on the youngish side. I was in the high category so I did chemo. There is so much more info for 50 and under women today than even 3 years ago.

  • Garnersuz77
    Garnersuz77 Member Posts: 44
    edited December 2019

    Hi scrafgal,

    “However, did you investigate recent findings about risk stratification for women 50 and younger?”

    What findings are you thinking about? I’d love to look them up. Thank you!


  • Scrafgal
    Scrafgal Member Posts: 631
    edited December 2019

    Garnersuz77

    A lot has been published this year about adding clinical risk factors, such as age, into the chemo risk oncotype score info. Tumor sizes over 3cm and being 50 and younger can make chemo a more appropriate treatment based on benefit vs. risk.

    Here is a link to an article from bc.org....

    https://www.breastcancer.org/research-news/adding-...

    I have also seen recent articles suggesting that lumpectomy plus rads does not have an equal outcome to mastectomy for 50 and younger.I don't know if research has been published to confirm this hypothesis.I never logged those since I had a mastectomy but it has been discussed.

  • Scrafgal
    Scrafgal Member Posts: 631
    edited December 2019

    A lot of the stats and treatment protocols use age 50 as a decision factor. This made things hard for me because I was diagnosed at 50! I am very healthy and want to live a long time. My other health stats said that my body was well under 50. I got treated as though I was under 50...aggressively.

    I posted this for Megoh too because I understand her anger at her MO who was insensitive. However, that doesn't mean that he is recommending chemo treatment without justification. Don't throw the baby out with the bath water...Check it out.

  • keepthefaith
    keepthefaith Member Posts: 2,156
    edited December 2019

    I was 58 at DX, did the onco test. Score was 21. I was not offered the BCI test. So, is the "new" cut off age of 50 related to the menopausal status? How did researchers come up with that age? Seems like they would use pre or post-meno if thats' where they got the age cut off of 50....? When I did the onco, it was before Tailor-X results came out. As it stands now, I probably would have skipped chemo. I was considered to be in the "intermediate range". My MO recommended, but did not push the chemo. I didn't do the mamma-print, because I did not want to wait for treatment to start. Nothing I can do about it now, but thankful we have research and studies always trying to give us better options and information. Do your due diligence, as hard as it may be, when you are anxious and scared. As of now, I have no known SE's from chemo....well, maybe worse teeth and bone loss...eh. No regrets; I did the best I could with the information I had at the time. Best wishes to you all. This forum is a blessing.

  • Scrafgal
    Scrafgal Member Posts: 631
    edited December 2019

    that is how I feel, keepthefaith...we do the best we can given what we know...

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