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@callalloo

It looks clear to me if I'm interpreting it correctly. I understand the sentence to indicate (correctly) that the OncotypeDX isn't considered useful in selecting the "kind" of chemo plan for those whom it considered would benefit from chemo. Since the OncotypeDX has zero to do with recommending any chemo prescription, the lack of consensus is appropriate though I'd rather the doctors agreed 100% that 'the type of chemo' isn't even being tested.

The people at Oncotype told me that they're still (after much doctor education efforts) hearing of physicians who have their patients take the OncotypeDX to make radiation selections, which the test is also not designed for.
[And, as noted in earlier posts, breastcancer.org is, incorrectly, reporting that the test determines whether one should have radiation. ]

So patients unfortunately just need to be very proactive, as most of us thankfully are here, in evaluationg information and data to get the valuable meaning out of it.

And I would be very concerned if my oncologists relied totally on the OncotypeDX either. Identifying and treating cancer is a process over time, starting with gathering quality data, making the best decisions at the time and changing course along the way as needed by results, newer/better meds, etc. The first critical information, to me, would be the post-surgical biopsy, signed off on by two pathologists I hope, that describes the mess of cells and their behavior. With hopefully wide-enough clean margins. Any two data points that seem to be in conflict would, for me, trigger retesting. Any doctor, lab or lab tech can make a mistake, mislabel a sample, have a bad day and pay insufficient attention to protocols, etc. So I hope that doctors are not relying solely on any one data point.

I sometimes think of the patient's responsibility for self-guardianship as the old adage of 'no rest for the weary' but it is what is is and can save a life.

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Replies to "It looks clear to me if I'm interpreting it correctly. I understand the sentence to indicate..."

In my case there was a dramatic difference between post-surgery pathology (grade 3, LVI, high ki67%) and Oncotype (low).

As for relying on lab technicians, well, one lab had me as HER2+, one had me as HER2 equivocal and one retested and got a negative- actually 4 different hospitals' labs.

If I had stayed with the first hospital I would have had chemo and been treated for HER2.

I asked for retests at three different oncology offices, and the tumor board also refused. The fourth doctor retested HER2 using 60 cells instead of 20. Ductal cells were positive but HER2- dominated so no Herceptin.

That 4th doctor also retested Oncotype and told me I could choose chemo if I wanted to. It was up to me. All the other oncos, two at major world class hospitals, relied entirely on the Oncotype.