@llthomson
It is ductal and they didn't get all the cancer when they done my mastectomy plus they removed 5 lymph nodes that were also positive for cancer, so now it's metastatic breast cancer. The signatera test was positive
@arminda Is it metastatic to the lymph nodes only or somewhere else like the bones? Those are both very low positives. Sometimes you can get positive results with cancer cells dying off.
My oncologist and a 2nd I went to in an attempt to get the test, both argued against it for the false positives and false negatives. Said it has not been thoroughly tested for the results. The other question both had, was how do you proceed with the results? If the result is false you could either do unnecessary testing or not test when you should.
I lobbied for it very hard!!! This the 2nd opinion. But neither would agree it was worth it.
@pbnew
I had my first Signatera test in Feb this year, 2026. The cost is sliding scale in a sense and the qualification for price reduction is very generous (youvcan have a fairly high income) but it was hard prying the info and the reduction from them. They all eagerly wanted to help but it just took a lot of back and forth and them not knowing their own criteria. So keep at it. They said almost everyone pays $0 however i am paying $249 instead of the full $500 for each test and they recommend having this blood test every three months. It was not covered by Medicare or my insurance. So. My household adjusted income on tax return is about $70k.
When I was first diagnosed, I asked for Oncotype test (for breast cancer). Was told test was not done for people over 70. Six months later, I changed medical oncologists, asked again for Oncotype. Result was a score of 29, so was put on Kisqali. I was already taking Exemestane. Medicare paid for the Oncotype.
If someone could comment on which test is best in which situations, I'd be grateful.
When I was first diagnosed, I asked for Oncotype test (for breast cancer). Was told test was not done for people over 70. Six months later, I changed medical oncologists, asked again for Oncotype. Result was a score of 29, so was put on Kisqali. I was already taking Exemestane. Medicare paid for the Oncotype.
If someone could comment on which test is best in which situations, I'd be grateful.
Oncotype DX test is a genomic test for early-stage, ER-positive, HER2-negative breast cancer that analyzes 21 genes in tumor tissue to predict the likelihood of cancer recurrence and the potential benefit of chemotherapy. I am so sorry that your first Oncologist seemed to miss the mark by telling you that it was not done for people over 70 thus delaying the treatment with Kisqali :(. Thank God that you changed your medical oncologist!
As for Signatera blood test for cancer patients, it is a personalized tool (custom-built for each patient by analyzing their specific tumor tissue to identify unique mutations), tumor-informed molecular residual disease (MRD) blood test by Natera (company name) that detects circulating tumor DNA (ctDNA) to track cancer recurrence (if there's any), and evaluate the effectiveness of this patient's ongoing cancer treatments. It is used to detect MRD after surgery for cancer patients with solid tumors, such as: colorectal, breast, lung, and muscle-invasive bladder cancer. This test is ordered by a physician, requiring both a tissue sample (from the patient's tumor) and regular blood draws (typically every 3 months) from the patient with stage II-IV cancers, as well as immunotherapy monitoring.
Sorry for such a lengthy note, hope it helps... I was over 70 when I had my surgery on 12/26/2023, and my surgeon sent my tumor tissue for an oncotype test right after the surgery. I am not qualified for a regular Signatera blood test; however, my PCP agrees with me to set up quarterly blood tests to check my tumor markers, such as: CA 15-3, etc., to make sure that my ongoing treatments plan is on the right track. I am very grateful for my kind-hearted PCP walking extra miles with me to assure me peace of mind!
To lifetraveler: Many thanks for this information. I'm glad I changed Med Onco as well! BTW, a different Med Onco told me that it's unclear if/how to change treatments plan based on results of Signatera. I think that's because circulating tumor DNA doesn't necessarily mean the existence of a solid tumor. Do you know anything more about this?
Also a question: are the blood tests for tumor markers covered by Medicare? So far, my Med Onco hasn't ordered any.
Many thanks in advance! Peg
To lifetraveler: Many thanks for this information. I'm glad I changed Med Onco as well! BTW, a different Med Onco told me that it's unclear if/how to change treatments plan based on results of Signatera. I think that's because circulating tumor DNA doesn't necessarily mean the existence of a solid tumor. Do you know anything more about this?
Also a question: are the blood tests for tumor markers covered by Medicare? So far, my Med Onco hasn't ordered any.
Many thanks in advance! Peg
Yes, what the other medical oncologist told you is true, that it's unclear how to change treatment plans based on the results of the Signatera test. This is because a Negative result suggests a lower likelihood of recurrence and the current ongoing treatments plan is on the right track, but a Positive result indicates the presence of ctDNA, oftenly identifying recurrence before it is visible on imaging. I think if the Signatera test shows a "positive result" with an elevating value of a patient's blood work over time, a competent medical oncologist should start thinking about something different to provide his/her patient with more effective treatments. This tool only indicates that it is time to re-evaluate the current treatment plan, but it won't tell folks how. Perhaps this is one of the reasons that not many medical oncologists favor this tool...
As for the question of whether Medicare covers the tumor markers blood tests, I truly don't know; for my PCP works at the hospital of a research university, she orders the quarterly blood work for me, I then go to the hospital for the blood test accordingly. Luckily for us, the values of my tumor markers have been staying relatively low ever since I started taking Anastrozole (one of the aromatase inhibitor medications treating patients with high ER+, PR+ BC), thus reassuring us the effectiveness of my current treatment. My PCP and I have an agreement though: should those values of tumor markers start trending higher than the normal range someday, we then need to bring it to the attention of my medical oncologist to re-evaluate my treatment plan. I guess we'll cross that bridge when we come to it... I am very grateful for my PCP's research oriented mind.
Sorry for such a lengthy note, my friend:(. Wishing you all a better journey ahead with hope, peace, and love!
Yes, what the other medical oncologist told you is true, that it's unclear how to change treatment plans based on the results of the Signatera test. This is because a Negative result suggests a lower likelihood of recurrence and the current ongoing treatments plan is on the right track, but a Positive result indicates the presence of ctDNA, oftenly identifying recurrence before it is visible on imaging. I think if the Signatera test shows a "positive result" with an elevating value of a patient's blood work over time, a competent medical oncologist should start thinking about something different to provide his/her patient with more effective treatments. This tool only indicates that it is time to re-evaluate the current treatment plan, but it won't tell folks how. Perhaps this is one of the reasons that not many medical oncologists favor this tool...
As for the question of whether Medicare covers the tumor markers blood tests, I truly don't know; for my PCP works at the hospital of a research university, she orders the quarterly blood work for me, I then go to the hospital for the blood test accordingly. Luckily for us, the values of my tumor markers have been staying relatively low ever since I started taking Anastrozole (one of the aromatase inhibitor medications treating patients with high ER+, PR+ BC), thus reassuring us the effectiveness of my current treatment. My PCP and I have an agreement though: should those values of tumor markers start trending higher than the normal range someday, we then need to bring it to the attention of my medical oncologist to re-evaluate my treatment plan. I guess we'll cross that bridge when we come to it... I am very grateful for my PCP's research oriented mind.
Sorry for such a lengthy note, my friend:(. Wishing you all a better journey ahead with hope, peace, and love!
@lifetraveler
I’ve had two Signatera tests both covered by Medicare parts B & G. However, I had to fill out an extensive questionnaire about my cancer details and family history so I think it’s case by case. I’ve been in treatment for recurrent breast cancer for 6 years, I have both the BRCA2 and CHEK2 mutations and a heavy family history of various cancers and early deaths. Both my tests were negative. Yay! Best of luck to all. ❤️
YES! A LOT OF A LITTLE INFO ADDS TO PEACE OF MIND. 8/2022 STAGE 2 BREAST AND A WORLD WIND OF TREATMENTS, SURGERY, AND LIVING THE "HAPPY NEW ME AND LEARNING TO ADDRESS SIDE EFFECTS.
MY SIGNATERA LABS ARE ALIGNED WITH MY 6-MONTH CITY OF HOPE CHECK-UPS. ALTHOUGH THERE IS NOTHING 100%, IT HELPS TO TAKE ADVANTAGE OF TEST THAT CAN POSSIBLE DETECT CHANGES. THE GOOD NEWS, RECENTLY NATERA APPROVED MY MISC LABS TO BE TAKEN AT SITE. REASON, I HAVE SMALL ROLLING VEINS, USUALLY A CHILD BUTTERFLY PIC WORKS. AS A HEALTHY YOUNG WOMAN IN 20'S DONATED BLOOD TO RED CROSS. AFTER 3 DRAW AND 2 NURSES PUMPING THEY SAID, THIS IS HARD FOR BODY, NO NEED TO DONATE AND IF LABS ARE NEEDED LET THEM KNOW, HARD PIC,ETC.
WITH RADIATION AND CALCIFICATION, I AM OFFICIALLY A HARD PIC. I GO TO NATERA LABS VS WITH PRAYER TRAVELING NURSE HAS EZ POKE. CORPORATE IN RIVERSIDE, CA APPROVED PATIENTS TO BRING THEIR OTHER LABS IN. HOPEFULLY, THIS WILL FOLLOW SUIT NATIONALLY.
PLEASE DO LABS, YOU WILL RECEIVE REPORT ON SIGNATURA CHART, YOUR DR,ETC.
ALIGNING LABS WITH CHECK UPS AND SEMI ANNUAL PCP CHECK UPS WITH THEIR LABS, IT SOFTENS THE HOKI POKI POKS AND GOD WILLING A CHERRY ON TOP WHEN ALL LAB TESTS ARE IN OUR HEALING FAVOR. PLZ DO LABS.
I would say Signatera test is a valuable tool. I was diagnosed with stage 2c high grade serous endometrial cancer with abnormal p53 in April 2025. Following surgery, I started chemo which I could not tolerate due to it causing severe neuropathy, heart issues, and high blood pressure. My oncologist hematologist recommended the test. I just had a low positive result after 2 negative test results and am scheduled for a PET scan.
I feel the tests are extremely important and can help guide treatment choices for patients like me that cannot tolerate chemo. They also can help determine if treatment is working. There are some oncologists that are not on board with the tumor-specific testing yet. They seem to be more concerned that there is not enough research behind it. However, there is new evidence coming out that validates the accuracy and value of this type of testing as it tailors treatment to the patient. Unfortunately, Cancer treatment “cookie-cutter” approaches (6 rounds of chemo, etc) for every patient needs to be revisited. Each one of us is different and our treatment plan should be focused on what works for each patient. My opinion, of course.
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@arminda Is it metastatic to the lymph nodes only or somewhere else like the bones? Those are both very low positives. Sometimes you can get positive results with cancer cells dying off.
My oncologist and a 2nd I went to in an attempt to get the test, both argued against it for the false positives and false negatives. Said it has not been thoroughly tested for the results. The other question both had, was how do you proceed with the results? If the result is false you could either do unnecessary testing or not test when you should.
I lobbied for it very hard!!! This the 2nd opinion. But neither would agree it was worth it.
@pbnew
I had my first Signatera test in Feb this year, 2026. The cost is sliding scale in a sense and the qualification for price reduction is very generous (youvcan have a fairly high income) but it was hard prying the info and the reduction from them. They all eagerly wanted to help but it just took a lot of back and forth and them not knowing their own criteria. So keep at it. They said almost everyone pays $0 however i am paying $249 instead of the full $500 for each test and they recommend having this blood test every three months. It was not covered by Medicare or my insurance. So. My household adjusted income on tax return is about $70k.
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Helpful -
Hug
2 ReactionsWhen I was first diagnosed, I asked for Oncotype test (for breast cancer). Was told test was not done for people over 70. Six months later, I changed medical oncologists, asked again for Oncotype. Result was a score of 29, so was put on Kisqali. I was already taking Exemestane. Medicare paid for the Oncotype.
If someone could comment on which test is best in which situations, I'd be grateful.
-
Like -
Helpful -
Hug
1 ReactionHi! @peggydobbs :
Oncotype DX test is a genomic test for early-stage, ER-positive, HER2-negative breast cancer that analyzes 21 genes in tumor tissue to predict the likelihood of cancer recurrence and the potential benefit of chemotherapy. I am so sorry that your first Oncologist seemed to miss the mark by telling you that it was not done for people over 70 thus delaying the treatment with Kisqali :(. Thank God that you changed your medical oncologist!
As for Signatera blood test for cancer patients, it is a personalized tool (custom-built for each patient by analyzing their specific tumor tissue to identify unique mutations), tumor-informed molecular residual disease (MRD) blood test by Natera (company name) that detects circulating tumor DNA (ctDNA) to track cancer recurrence (if there's any), and evaluate the effectiveness of this patient's ongoing cancer treatments. It is used to detect MRD after surgery for cancer patients with solid tumors, such as: colorectal, breast, lung, and muscle-invasive bladder cancer. This test is ordered by a physician, requiring both a tissue sample (from the patient's tumor) and regular blood draws (typically every 3 months) from the patient with stage II-IV cancers, as well as immunotherapy monitoring.
Sorry for such a lengthy note, hope it helps... I was over 70 when I had my surgery on 12/26/2023, and my surgeon sent my tumor tissue for an oncotype test right after the surgery. I am not qualified for a regular Signatera blood test; however, my PCP agrees with me to set up quarterly blood tests to check my tumor markers, such as: CA 15-3, etc., to make sure that my ongoing treatments plan is on the right track. I am very grateful for my kind-hearted PCP walking extra miles with me to assure me peace of mind!
Wishing you all a better journey ahead!
-
Like -
Helpful -
Hug
4 ReactionsTo lifetraveler: Many thanks for this information. I'm glad I changed Med Onco as well! BTW, a different Med Onco told me that it's unclear if/how to change treatments plan based on results of Signatera. I think that's because circulating tumor DNA doesn't necessarily mean the existence of a solid tumor. Do you know anything more about this?
Also a question: are the blood tests for tumor markers covered by Medicare? So far, my Med Onco hasn't ordered any.
Many thanks in advance! Peg
-
Like -
Helpful -
Hug
2 ReactionsHi! @peggydobbs :
Yes, what the other medical oncologist told you is true, that it's unclear how to change treatment plans based on the results of the Signatera test. This is because a Negative result suggests a lower likelihood of recurrence and the current ongoing treatments plan is on the right track, but a Positive result indicates the presence of ctDNA, oftenly identifying recurrence before it is visible on imaging. I think if the Signatera test shows a "positive result" with an elevating value of a patient's blood work over time, a competent medical oncologist should start thinking about something different to provide his/her patient with more effective treatments. This tool only indicates that it is time to re-evaluate the current treatment plan, but it won't tell folks how. Perhaps this is one of the reasons that not many medical oncologists favor this tool...
As for the question of whether Medicare covers the tumor markers blood tests, I truly don't know; for my PCP works at the hospital of a research university, she orders the quarterly blood work for me, I then go to the hospital for the blood test accordingly. Luckily for us, the values of my tumor markers have been staying relatively low ever since I started taking Anastrozole (one of the aromatase inhibitor medications treating patients with high ER+, PR+ BC), thus reassuring us the effectiveness of my current treatment. My PCP and I have an agreement though: should those values of tumor markers start trending higher than the normal range someday, we then need to bring it to the attention of my medical oncologist to re-evaluate my treatment plan. I guess we'll cross that bridge when we come to it... I am very grateful for my PCP's research oriented mind.
Sorry for such a lengthy note, my friend:(. Wishing you all a better journey ahead with hope, peace, and love!
-
Like -
Helpful -
Hug
2 Reactions@lifetraveler
I’ve had two Signatera tests both covered by Medicare parts B & G. However, I had to fill out an extensive questionnaire about my cancer details and family history so I think it’s case by case. I’ve been in treatment for recurrent breast cancer for 6 years, I have both the BRCA2 and CHEK2 mutations and a heavy family history of various cancers and early deaths. Both my tests were negative. Yay! Best of luck to all. ❤️
-
Like -
Helpful -
Hug
2 ReactionsYES! A LOT OF A LITTLE INFO ADDS TO PEACE OF MIND. 8/2022 STAGE 2 BREAST AND A WORLD WIND OF TREATMENTS, SURGERY, AND LIVING THE "HAPPY NEW ME AND LEARNING TO ADDRESS SIDE EFFECTS.
MY SIGNATERA LABS ARE ALIGNED WITH MY 6-MONTH CITY OF HOPE CHECK-UPS. ALTHOUGH THERE IS NOTHING 100%, IT HELPS TO TAKE ADVANTAGE OF TEST THAT CAN POSSIBLE DETECT CHANGES. THE GOOD NEWS, RECENTLY NATERA APPROVED MY MISC LABS TO BE TAKEN AT SITE. REASON, I HAVE SMALL ROLLING VEINS, USUALLY A CHILD BUTTERFLY PIC WORKS. AS A HEALTHY YOUNG WOMAN IN 20'S DONATED BLOOD TO RED CROSS. AFTER 3 DRAW AND 2 NURSES PUMPING THEY SAID, THIS IS HARD FOR BODY, NO NEED TO DONATE AND IF LABS ARE NEEDED LET THEM KNOW, HARD PIC,ETC.
WITH RADIATION AND CALCIFICATION, I AM OFFICIALLY A HARD PIC. I GO TO NATERA LABS VS WITH PRAYER TRAVELING NURSE HAS EZ POKE. CORPORATE IN RIVERSIDE, CA APPROVED PATIENTS TO BRING THEIR OTHER LABS IN. HOPEFULLY, THIS WILL FOLLOW SUIT NATIONALLY.
PLEASE DO LABS, YOU WILL RECEIVE REPORT ON SIGNATURA CHART, YOUR DR,ETC.
ALIGNING LABS WITH CHECK UPS AND SEMI ANNUAL PCP CHECK UPS WITH THEIR LABS, IT SOFTENS THE HOKI POKI POKS AND GOD WILLING A CHERRY ON TOP WHEN ALL LAB TESTS ARE IN OUR HEALING FAVOR. PLZ DO LABS.
-
Like -
Helpful -
Hug
2 ReactionsI would say Signatera test is a valuable tool. I was diagnosed with stage 2c high grade serous endometrial cancer with abnormal p53 in April 2025. Following surgery, I started chemo which I could not tolerate due to it causing severe neuropathy, heart issues, and high blood pressure. My oncologist hematologist recommended the test. I just had a low positive result after 2 negative test results and am scheduled for a PET scan.
I feel the tests are extremely important and can help guide treatment choices for patients like me that cannot tolerate chemo. They also can help determine if treatment is working. There are some oncologists that are not on board with the tumor-specific testing yet. They seem to be more concerned that there is not enough research behind it. However, there is new evidence coming out that validates the accuracy and value of this type of testing as it tailors treatment to the patient. Unfortunately, Cancer treatment “cookie-cutter” approaches (6 rounds of chemo, etc) for every patient needs to be revisited. Each one of us is different and our treatment plan should be focused on what works for each patient. My opinion, of course.
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Like -
Helpful -
Hug
3 Reactions