Oncotype Dx test...

SKHunt--as you are post-menopausal, node-negative with a low oncotype score, I'm really surprised they're not suggesting hormonal therapy for you. I think the second opinion in your case is a good idea.

My score was 18, but I had a large tumor (2.7cm) and was 38 at diagnosis. So I chose chemo, but if I had been in my 60's at diagnosis, I would've gone with hormones only. 

SKHunt, that is a big tumor, and you're right, that's why they're probably saying chemo. What grade is the tumor (1, 2 or 3)? That plays into it, too. I'd be more inclined to do chemo with a grade 3 tumor than a grade 1.

Yes, tamoxifen (hormonal therapy) is the pill one takes for five years.

dkhunt,

I'm 44, also er & pr + no nodes, my score was 12 and therefore my onc said no chemo just rads.  I feel very comfortable with my decision as I know I will be vigilant about follow ups and so forth.  My onc said to me that the side effects and % of recurrence with such a low score that the chemo was not justifiable.  Hope this helps you on your journey.

Trish

Hello Everyone,

   This is my first time on the list. Thanks for great information. I was diagnosed with BC in July. ER+, node negative.2.3 cm.Very low(negative) HER2. Lumpectomy in Aug.Had Mammosite targeted internal radiation last week. Had oncotype done (thru insurance - not sure about payment outcome yet). got recurrance score of 15 .Am very glad had it done. Am now collecting info about chemo/hormone therapy since I am in the grey area. Appt. with chemo doc Oct 5. Any other "grey areas" out there?!

HI Urbie and amyrlcsw,

I've posted on this several times. I got a 16 on Oncotype, and my onc. couldn't steer me one way or the other. I got a second opinion and he felt I should do it because it was grade 3  and 1.9 cm. I have 2 children and wanted to do everything possible to fight this. I also had a bilat. mast. in July. Fortunately, I won't need rads. I have had 2 of 4 Taxotere/Cytoxan treatments and it's been completely doable. Except for a few days after treatment when I'm really tired, I've been leading a normal life. Good luck!

Eve

Hi Urbie,

I hate to say it, but I've been one of the lucky ones who hasn't had any nausea with this treatment. My onc. had told me it was much easier to tolerate, and so far it's been true. They do give me anti-nausea meds in the IV, but I haven't had to use anything else (they gave me rx's for compazine and zofran).  I do take an Ativan at night to help me sleep and make sure nothing happens with my stomach during the night. I have had heartburn, a horrible taste in my mouth and fatigue. I have also been getting acupuncture. Don't know if it's helping, but it can't hurt and is very relaxing. I just make sure to have down time for a few days after my treatments. My kids are very helpful, and I don't really care what my house is like, if laundry is done etc... during that time. Good luck. I'll be thinking about you on Monday.

Hi llivtswm - Why did they take 40 lymph nodes?  Do they not do sentinal node biopsys in Canada?

I am VERY Pro Oncotype DX Testing



I was one of the earlier takers of the test back in June of 05. I was Stage 1, Grade 2, 1.1 cm tumor, ER+100/Pr-, node negative, no lymphovascular invasion. I was in the grey area for chemo though my onc was pushing for it because of my age, 33. I got the test done and scored 36 which is high, it means a 25% chance of recurrance without chemo.



I trusted the test and did AC&T x4 dose dense then went on to do Tamoxifen and Lupron. November of 2006 I metastize to my bones and validate that test. Everyone including my oncologist was shocked that I recurred. That high score always made me nervous.



Get the test done. My insurance denied it and it went to every level of appeal. They billed me very long after that, at least a year after the test. They offered me a payment plan and I said I couldn't pay. I haven't received a bill since and that was close to a year ago. I think/hope they wrote it off.



Amy

I just received my Oncotype score which was 11. My doctor is part of the group doing the research on using Oncotype with positive or negative lymph nodes.  I have IDC tumor 2.2, Grade I, ER(4+)PR(4+), negative lymph nodes, but "few Isolated Tumor Cells".  My doctor is very comfortable with my decision to opt out of chemo.  I also had my ovaries removed and lumpectomy w/radiation.  I will start Arimidex after the rads.  Anyone else have a diagnosis similar?

Melissa

Has anyone enrolled in the Tailorxtrial had this concern:  when my oncotype report came back and the doctor gave me a copy, my name and all identifiers were blacked out.  It is a big decision to rely on this score to determine your future, and I think I should have a report that I am sure is mine, and that shows they tested the right tumor (original surgery, not re-escision).  For some reason I am having a hard time getting that.  Am I unreasonable to expect it?  Is there something about the trial that requires this?  Thanks. 

My name was blacked out but you could still see through the marks that it had my name, DOB and date of surgery correct.  I scored a 9 so my oncologist said, "no chemo".  He didn't even entertain the idea.  My cancer was ILC, 1.1 cm, no nodes, clean margins except for a few scattered cytokeratin positive single cells which made me nervous.  The doctor said it was probably a result of the surgery spreading the cells a little but chemo wasn't necessary.  I am doing great and taking Tamoxifen since I finished rads.  I think I will change to Armidex next year and continue with that for 5 years.

My best friend was diagnosed with breast cancer about a month and a half ago.  She just turned 58 years old.  She had a 1.2cm grade 1 tumor that was ER positive, 3 lymph nodes were taken and all were negative, it was a slow growing, "non-aggresive" tumor.  Very low risk of bc reoccurence based on the personality profile of her cancer. She has a masectomy a month ago because she also had speckling of DCIS throughout her breast in addition to the tumor.  When discussing her treatment therapies, arimidex was a given, but there didn't appear to be a benefit from chemo. 

When her doctor brought up the onco test, my friend almost passed it up.  She just got her recurrence score back today and she is a 56, which carries a 34% risk of cancer reoccurence in the next 10 years.  Please don't assume your treatment without getting the onco gene test.  It's well worth the money in comparison to your health/well being and quality of life.  The personality of cancer is just that.  It's subjective.  That is why they've made progressions into gene mapping and science that is more reliable than guessing based on characteristics that may or may not be always be accurate.  Just my 0.02 for those of you questioning the impact that this test may have on you and your families. 

I do not know why your onc is still recommending chemo with a score of 12.  I'd ask the oncologist that specific question and have him explain why he's recommending chemo.   I'd also seek a second opinion from another oncologist.  

I wanted to way in on the Onco test also.  I had the test done when it was relatively new.  June of 2005.  I had a 9 mm tumor, node negative, grade 2 and the onc said that all the characteristics of the tumor made it a good prognosis for no chemo.  I was 44 years old so they were a little concerned about my age.  My wonderful (and up-to-date) onc insisted on Onco test.  We were shocked when it came back 33 1/2.  I ended up doing dose dense chemo, 4 rounds of AC and 4 rounds of taxotere.  My onc said that just 9 months previously they didn't even have the test available and I would have ended up not doing chemo.  At that time my onc said that it was the highest score she had seen.  Now there have been many more women tested and I'm sure she has seen these high scores since.  Also, my insurance paid for half the test and Genomic Health called me to let me know that they were righting off the rest.  Bless them. 

I got a score of 20  ( 12% of recurrence) and my oncologist said no chemo because my tumor was 5mm, 100% Er positive 95% pr, no nodes, stage 1, grade 1. Since I am so hormone positive, we are just doing radiation and taxofin. I am 36.