• Oncotype DX Breast Cancer Assay Experiences?

    Asked by dealite2007 on Wednesday, November 28, 2012

    Oncotype DX Breast Cancer Assay Experiences?

    Has anyone had the Oncotype DX assay done? And, why did your doctor recommend the test and did you end up with chemo?

    I had a lumpectomy Nov. 14th. I just left my medical oncologist office and she recommends I get it because she believes I need chemo. I only question this because my radiation oncologist, breast cancer surgeon and (2nd opinion surgeon also) all said they doubted I'd need chemo---just radiation. Here are my stats:
    Stage 1a
    ER: yes
    PR: yes
    Her-2: no
    Ki-67: 25% (This is the factor the Medical Onc. says indicates a possible need for chemo.

    But, it's my understanding that chemo is only good for under 10% of early stage, lymph node- negative and estrogen receptor-positive breast cancer like mine.

    Does anyone have any thoughts on this?
    I don't want to have chemo if it's not going to do any good..

    11 Answers from the Community

    11 answers
    • nancyjac's Avatar

      I think the most important thing to remember is that you are not a statistic. Each cancer, like each individual is unique.

      Oncotype DX was initially developed for women with early-stage invasive breast cancer with ER+ cancers whose lymph nodes do not contain tumor (node-negative). Typically in these cases, treatment with anti-hormonal therapy, such as tamoxifen or aromatase inhibitors, is planned, and the test can help define whether chemotherapy should or should not be added to that anti-hormone treatment.

      The problem is that those statistics can only be based on people who have not had a recurrence since they started measuring, which was only about 5 years ago. I have no idea how that 10% statistic was derived, but the more important thing to know is that it only applies to any results within a period of 5 years. The unfortunate, but obviously true thing is that all statistics are like betting on horse a craps table or buying a lottery ticket. Regardless of the odds, the only way you will know if you win or not is by placing the bet.

      My recommendation is that you go ahead with the assay (it can't hurt) and then make your decision on chemo based on the risks of having chemo vs. the risks of cancer recurrence, especially 5 years out or longer.

      almost 5 years ago
    • Nancebeth's Avatar

      I did the Oncotype DX testing. I was stage 1, 1.9 cm tumor with no lymph node involvement. ER+, PR+, HER2 Neg. My Oncotype score was 24 which was right in the middle so chemo was recommended but not required. I had chemo (CMF) every 21 days for 6 sessions. I am happy with my decision although chemo was no picnic!

      almost 5 years ago
    • Nancebeth's Avatar

      Oh, also, I wanted to add that the Oncotype DX testing is considered genetic testing so if you are insured, make sure your insurance plan covers genetic testing. Mine says they do, however, they don't cover genetic screening. They are now trying to say this is a screening not a test and I have been going through the appeal process. The test costs $4100.00.

      almost 5 years ago
    • BetsyP's Avatar

      I recently had the Oncotype DX done and found out my score was 22 - on the low end of the intermediate risk scale. I'm stage 2a, 2 cm, ER yes HER-2 no, no lymph node involvement. However, I have LVI and my doctors felt the Oncotype would better help me decide if chemo would further reduce my future risk. With a score of 22, I would reduce my risk by an additional five percentage points. Of course I realize this is no guarantee, but I'm willing to undergo chemo in the chance that it buys me more time. As I look at it, this may be my only opportunity to bank for the future. I'm starting my first round tomorrow - then up for three more rounds every three weeks. I'll be halfway done by Christmas.

      For me personnally, I would recommend the test. The more information you have, the better your decision making. Good luck!

      almost 5 years ago
    • dealite2007's Avatar

      Thanks everyone for your responses. I've told my doc to move forward and I've put my warrior wings on to battle with my insurance company about coverage. I've had to call on every single bill because they've denied everything...until I call then it's paid. I believe in my heart it's automatic for them to deny claims in hopes no one appeals. Well, not me, honey. I need a distraction right now and battling with the insurance company (Blue Cross Blue Shield of Maryland) will do just fine.

      almost 5 years ago
    • karen1956's Avatar

      I didn't have oncotype test...not sure if it was out in 2006, but I had positive nodes....I had bilat, chemo, rads, AI's....Was stage 3A....

      almost 5 years ago
    • sjjohnson1's Avatar

      I had the test done even though my tumor was very small. The doctor thought I would not need chemo and when the results came back my cancer was likely to return. So, chemo here we come. Doctor was shocked at the results, but said that is why we do the test. Glad I did because I want to know I have done everything I can in my fight.

      almost 5 years ago
    • fallsbs' Avatar

      For anyone concerned about the cost of Oncotype DX, the lab that performed my test has a "financial aid" department . If they determine you qualify for assistance, there will be no out of pocket cost. They did not volunteer this information at first, so ask questions

      almost 5 years ago
    • lynnh's Avatar

      I had a lumpectomy and had the Onocotype testing done and my oncologist also recommended chemo. Before the testing, I was also just expecting to have radiation. Also during the time after the lumpectomy and deciding course of action, I also had the testing done for the BRCA gene. When that test came back positive for BRCA2 gene, I got pulled out of radiation and decided to have double mastectomy. In hindsight, my breast surgeon said she should have ordered the BRCA test before the lumpectomy. That would have given me more informaiton to make the decision of treatment. I ended up with chemo after the mastectomy based on the pathology of what was removed in the surgery. I just recommend that you are armed with all the information before you decide your course of action.

      almost 5 years ago
    • Echuck's Avatar
      Echuck (Best Answer!)

      I had the test a little over 5 years ago, it came inclusive basically. I went toxmifern for almost 4 years, I could not stand the side affects any more so I stopped taking it, 8 months later I was diagnosed with stage 4 cancer 3 tumors on my liver and cancer in muscular chest cavity and in spine. I am doing ok now but live from day to day. I would highly recommend chemo to make sure you get all. I had had node that some microcopic cancers in it that they found when they did the original surgery but I am now sure now that some into the blood stream 5 years ago. Chemo is the sure way of destroying any cells that escaped surgery.

      almost 5 years ago
    • ChaChamom's Avatar

      I was stage 1a, multi focal IDC with the largest tumor only 3mm; ER+, PR+, HER2+++
      My first MO, recommended no chemo due to the small size but I was concerned about the HER2+++ and asked for an Oncotype. He wouldn't order it and I went to a second MO ( in the same system of care) and my new MO didn't hesitate to order it. It came back at a 20 (low intermediate), and she concurred that the chemo was potentially more harmful long term than no chemo. I'm on Tamoxifen for a year and then will switch to an aromasin. I'm comfortable with this plan now and feel I have the option of doing the chemo if I have a recurrence later.

      almost 5 years ago

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