Genetic testing for breast cancer Revised guidelines

@callalloo just to clarify the term "biopsy." My HER2+ was from initial biopsy, when the doc takes a very small piece of a possible cancerous area and tests it. My HER2 equivocal/negative was from pathology lab testing after surgery. I just wanted to make sure that was clear since you used the term "post-surgery biopsy." I consider "biopsy" and "post-surgery" testing to be two different things but I can see how they might be used that way. Post surgery though the entire tumor has been taken and made into identifiable "blocks." In my case the blocks all had some different characteristics so in seeking more testing I had to become familiar with each and select the one I most wanted information on.

I could be using the term incorrectly. I had the initial wide-needle vacuum-assisted* biopsy after the mammo and ultrasound spotted a suspicious area. And then a biopsy of the tumor tissue excised in surgery. I think of the latter as the post-surgery (and more comprehensive) biopsy.

I had an oncotype number of 10 so I needed no chemo. After 5 years of anastrozole I had a breast index. It came back as 11% recurrence. I am taking anastrozole for another 5 yrs. Does that sound right?

I'm assuming the 10% risk number that would have been closer to 18-20% if you'd rejected the drugs.
And luckily you've done well and dodged those 10% 'odds' of recurrence. So it sounds as if the drugs have worked and it would make sense that the risk, based on genetics, remains about the same as both tests test genes. Though there's variance in the algorithms and the tests are done to answer a different question.
Had genetic mutations occurred on the alleles targeted by the tests, your risk would likely have worsened. So it's a question of continuing the drugs (which makes sense) or again looking at a higher double-digit risk. If you tolerate the drugs OK, and monitor for osteoporosis, taking the drugs seems wise. How are you looking at it?

The Breast Cancer Index tells you yes or no, whether extended endocrine therapy is of any benefit. This is unrelated to risk. In other words, you can be of high risk but not benefit and you can be of low risk and still benefit. @huey it sounds like you were classified as high risk by the BCI but still benefit from more years on the meds.

ps @callalloo with a score of 10 on the Oncotype, I would assume a risk of, say, 6% or something like that.

I’m taking anastrozole for 5 more years. My bone density is ok

The oncotype number is not a percentage.

The recurrence risk is a percentage, the score is not.

So @huey your BCI was high risk and also showed benefit from continued anastrazole. Mine was high risk but showed no benefit from extended hormonal therapy.

Hi! New here. Im about to start my journey on AI's and in my research have found so many similarities between the different meds (with highlight on the concerns I have) I almost feel like its a crap shoot, and to go with one and see how it works and if there are too many side effects try another. I am 53 yrs old and this has been a pretty quick ride so far. My biopsy results (March 16) Invasive Lobular Carcinoma Early Stage (right breast). Surgery Was May 6 ( I opted for Double Mastectomy w/o reconstruction) and the pathology came back Invasive Ductal Carcinoma with Lobular features there was a lymph node excision and thankfully they came back negative. Pathology from surgery Grade 2 Stage 1 ER 100% PR 95% HER2 negative. I just received my Oncotype score today (13) I was also lucky enough to be able to have Genetic Cancer testing done and none of the genetic cancers came up ( I dont know if thats something smaller offices offer, God answered my prayers and I was able to get in at Duke). I am very happy with both my Surgical oncologist and my Medical Oncologist. They are both informative and take the time to answer questions. I had a partial hysterotomy back in 2003 (pre cancerous cells) so they ran hormone tests to confirm that I am post menopausal. My concerns focus highly on the depression and anxiety as I do have mental health dx Bi Polar & Generalized Anxiety prior dx of depression. Currently on Seroquel, Buproprion and Xanax. My other concerns are the Brain Fog/Memory issues. Anyhow, I just wondered if there was anyone with a similar history. Age? Hysterectomy, mental health history of dx or meds as I really wonder how much that effects things. Or any information at all honestly. My Dr. wants me to start on Anastrazole and will be calling in the rx in the next couple of days as soon as he gets the go ahead from me. We adopted our grandson who is now 11, I have to be functional. I see so much in regard to Quality of life vs quantity. Am I wrong to want both? TIA!

sorry, I dont know how I switched threads, I meant to put this in the Aromatase Inhibitors: Did you decide to go on them or not? thread