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Genetic testing for breast cancer Revised guidelines

Breast Cancer | Last Active: Jul 26, 2022 | Replies (41)
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@windyshores

@eku The Oncotype is used at the time of diagnosis, and gives the risk of recurrence, so I don't think it would be used for metastatic breast cancer.

I also had HER2+ then equivocal then negative. But close to the line for positive. As I wrote above, it seems tje ductal part of my cancer was positive and the lobular part was negative. I am going to read what you posted about "low" HER2.

ps here is text on who can use the Oncotype: Oncotype DX helps predict the chance of metastasis and the likelihood of benefit from chemotherapy for early breast cancers that are all of the following [14,32-34]:

Tumor size smaller than 5 cm
ER-positive (and will be treated with hormone therapy)
HER2-negative
Lymph node-negative or 1-3 positive lymph nodes

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Replies to "@eku The Oncotype is used at the time of diagnosis, and gives the risk of recurrence,..."
eku | @eku | Jun 15, 2022

Here's some more info on the "low" HER2.
The clinical trial is called: DESTINY-Breast04
https://ascopost.com/news/june-2022/fam-trastuzumab-deruxtecan-nxki-doubles-progression-free-survival-in-her2-low-metastatic-breast-cancer/

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callalloo | @callalloo | Jun 15, 2022

I might tweak that comment. There are sometimes diagnoses done before surgery but the OncotypeDX is done with tumor tissue removed at the time of surgery. So it's usually a post-surgical test and is done specifically to offer a risk/reward evaluation of chemo for the client whose tissue was submitted if the person has not has chemo or radiation.

BUT, it also provides a predicted risk of recurrence, local or regional, within 9 years if that client does not do chemo but did take anti-hormone therapy. Since anti-hormone therapy is currently considered to reduce risk of recurrence by 40-45%, one can calculate the risk of recurrence is one does NOT take anti-hormone therapy based on that number.

Radiation is not addressed by the OncotypeDX except that the test statistical model is based on not having had chemo or radiation within 2 years previously, for any cancer in the body.

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