@colleen after I posted that, I posted info on a study that showed that radiation benefited those with low or medium Oncotype scores, but not those with high Oncotype scores. I posted a link. This is counterintuitive and I kind of wonder is any doc is saying, well, the Oncotype score shows low risk so you had better have radiation!! (In fact I got the opposite!)

I had initiallly suggested to @callalloo exactly what you are suggesting: that the score could be used for guidance about radiation. But perhaps things are more complicated. Then again, this was just one study!

Darn, I'd hoped we'd finally clarified this and dropped the subject which I wish I'd never brought up in the first place p but only did so to help others dealing with breast cancer and it's often-opaque decisions. And benefit from the hours I put into learning from Oncotype exactly what one could reasonably infer from OncotypeDX results.

Sorry, but Dr. Pruthi's statement is in direct conflict with what I have been told, four times now, by Oncotype management and further confirmed by a scientist who worked on the creation of the test. And conflicts with what Oncotype's legal department cleared in a letter to me.

It also conflicts with the text from Oncotype's website, which you included, which also makes no mention of radiation inferences which the OncotypeDX test can be used to support.

The only treatment decision the test is designed to 'predict' is a theoretical expected overall benefit of adjuvant chemotherapy, all other things being equal.

So the doctor's statement, if quoted accurately,  that 'the "Oncotype DX test is not used only to predict the benefit radiation..." is incorrect and would be denied by Oncotype.

That is, it is not only "not ONLY used to predict the benefit of radiation" it is, in fact, not used at ALL to "predict the benefits of radiation."

It's discouraging that physicians are so clearly not reading the OncotypeDX literature, stats, cohort studies or website. And mystifies me. But if doctors don't understand the OncotypeDX, patients are being misinformed and that's a problem.

If, by some non-obvious logic, Dr. Pruthi is using the OncotypeDX's Recurrence Score or Risk Score to make assumptions on her own in some way, about the benefits of radiation, that would be a use of the algorithm not intended, encouraged or supported by Oncotype according to Oncotype. That is she would be predicting, but not the science-based objective genetics-focused OncotypeDX.

Or perhaps the doctor is thinking of some other test entirely? [One problem with Oncotype tests, which some there afpgreed with, is the very similar names for very different tests. As they continue to develop more tests, it could be a patient-physician nightmare. It might be possible to, in a round-about way, to make some treatment inferences based on the Oncotypr DX Breast DCIS Score Test but that tests a different cancer than is eligible for OncotypeDX. Apples and oranges...