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oncotype RS of 27
I am a 71 y/o female with an oncotype score of 27, ER+ PR- Her2(-) . luminal b ( my biopsy came back PR+ but once the tumor was removed it tested PR-) my scans measured the mass at 12mm but once it was removed , a month later, it was measured at 23mm. Nodes are negative. had a lumpectomy and awaiting radiation pending my oncotype score. My oncotype score is 27, giving me a 16% chance of distant recurrence with radiation and no chemo , or approx 9.6 % chance of distant recurrence with chemo + radiation. at the moment no one has recommended the RSClin tool. Since my score is 27, so close to a no chemo recommendation of 25, the decision for chemo is a difficult one. My other concern is the big difference in tumor size change over the span of just a month or so. Has anyone had a similar experience. I was told that it is unusual for the size to so different between the scan and the actual size, my med onc was going to request the scan be re read. Thanks for any insights
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@pat9892 I’m not sure I understand the comment about re-running the numbers. My understanding is the ER, PR and HER2 numbers are run on the tumor to determine its makeup. Same with the Ki67 and oncotype. Doing treatments wouldn’t change any of these? If they were rechecked, it would be done off the same tumor tissue that was saved, not a blood test. Are there other numbers that should be rechecked? My oncologist uses the Cea and tha Ca27-29 tumor markers and rechecks these regularly. There are some who don’t recommend them because they aren’t totally accurate (and it has caused some problems with my treatment) but they are blood markers, not actually tumor tissue markers.
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My initial numbers were from a fine needle biopsy (A very small sample of tumor tissue). Once the tumor was taken out and tested , a couple of the numbers were significantly different, My PR %went from 42 to 0 , my KI 67 went from 21-30 to 6-10 . This changed my diagnosis from luminal A to Luminal B. Also , as soon as I found out the fine needle biopsy came back as ER + , I immediately stopped my estrogen replacement therapy which was probably responsible for lowering my KI 67 score … since it was 21 days before the mass was removed
@skhenderson54 wow, I kind of depended on them to tell me if anything changed since staging was done after surgery. I never checked (still a little shell shocked at the time I guess) but I’m going to go back to the post surgery report and see if they retested and if anything changed. I do think they sent the tumor in for recheck so should be there. Appreciate the input.
Although I asked for it on my very first visit to a renowned cancer center, I was told that Oncotype was not offered to those over 70. I was 81 at the time. I had 2 surgeries and radiation treatment there.
I eventually changed institutions (this time a renowned medical center, but not a cancer center), got the Oncotype test, had a score of 29 and was put on Kisqali in addition to exemestane (which I was already taking). My cancer was ER+Pr-HER2-, grade II/III, stage pT1c, no nodes sampled (because I was over 70).
I'm wondering if some of the assumptions about cancer being less aggressive if one is older are true.
@skhenderson54
My oncologist told me that the ki67 numbers vary greatly depending on where in the tumor they are taken from. The pathologist would know this.