No, he got those criteria correct. The onco radiologist said I had a 10% chance of recurrence in the same area as lumpectomy, which she could reduce to 2%. But only in that exact small area. This was before we received the OncotypeDX result which showed I have a 3% chance of "local or regional recurrence within 9 years" (e.g., anywhere on the body) based if I take a SERM or AI and X< 1% benefit from chemo. And (!) assuming that I had not taken either radiation or chemo before the tumor tissue sample was excised and sent for testing. That is, the OncotypeDX test is solely to help evaluate the risk/reward profile of chemo for that patient, for that tumor, with the 21 genes they analyze. Period. It excludes radiation from any consideration and is both predictive and prognostic with the latter being only with respect a chemo risk/benefit payoff.

That 3% risk translates to 5-6% if I don't take anti-hormone meds and already assumes I didn't have radiation.

But the radiologist continued to insist that I have a 10% chance of recurrence in the lumpectomy area that radiation could reduce to 2%. And the oncologist deferred to her though her pre-genetic-testing stat cannot remain applicable unless the OncotypeDX is garbage.

Here's my logic as I used when showing the OncotypeDX result to the surgeon, PCP and endocrinologist.

Let's assume that all people with, say, brown hair have a 10% risk of something where 10% is a rough industry standard based on statistics collected over time and not even representative of only current standards. One can say that I 'had' that crude 10% due to hair color (for stage 1A invasive DCIS that is ER+, PR+ and HER‐ tumor) and appropriate for the OncotypeDX protocol as mine was.

Assume further that left-handed brown-haired people with have a 3% risk (as the test suggested I have) for that 'something.'

That is I am in the subset of the data pool with 3%. The radiologist argued (fallaciously) that the 3% requires that I have radiation and the oncologist deferred to her...even though the OncotypeDX criteria specifically contradict that statement. And those doctors are dealing with patients at a very critical point in their lives when it is negligent to defend indefensible refusal to correctly advise patients as to what a test does and means.
But I digress.

The endocrinologist applauded me for being proactive in confirming the accurate interpretation. He said that 'we specialists' can sometimes over-focus on a small tree and miss the forest. And he learns a lot from his patients who are proactive and double-check their options.

The most senior person I spoke to at Oncotype deals primarily with calls from doctors and nurses and said that some recommend the DX test to determine whether radiation is advised which is a complete misunderstanding of the test, which is strictly to help in a post-surgery chemo decision. One aside that I found interesting is that the OncotypeDX test sometimes sees evidence of invasive cancer in tissue mislabeled or incorrectly under-diagnosed. So they immediately notify the medical provider.

By the way, Oncotype is writing both doctors (not mentioning a patient's query) to re-emphasize that radiation is a precluding criteria for the OncotypeDX and no assumptions about post-test radiation were studied or included or can be inferred.

I think that this situation bothered me so much because radiation, in my case of the left breast, is a serious decision and, if regretted later, undoable. And I would be the person living with the consequences of any of these decisions <wink> so might have a different risk-regret profile than the medical professional citing statistics. And I'm skeptical about statistics anyway until I can research their source and quality. A former economics professor used to quote Mark Twain's 'there are lies, damn lies and statistics.' IF the OncotypeDX is relatively valid, hormone therapy would reduce my risk of recurrence by 40-50% which is huge. But it's a huge reduction of a small number to an even smaller one of 3% versus quality of life being older and having lost time and opportunities we all aready lost because of covid.

PS Sorry for such a long post but I've seen several websites that say the OncotypeDX predicts benefit of radiation so a lot of readers might also have that misunderstanding. Once something incorrect is online, it tends to be reposted ad nauseum by other content-hungry sites. So caveat emptor as knowledge is power.