Hi Randy,
OK here's what I learned from talking to the Oncotype people (at Exact Sciences) today including the person I think of as 'the science guy because he's the person physicians call but helped me a lot when I was trying to understand what the OncotypeDX tested and its algorithm when I had a lumpectomy last October.

The OncotypeDX would be invalid if the client had already had aromatase inhibitors, radiation or chemo. So the letrazole would preclude valid results from an OncotypeDX test.

BUT, they do accept tissue for analysis from biopsies with the following caveats and maybe this gives you an option. The rep did note that some insurance companies won't cover biopsy genomic testing but that's a different issue.

1. The sample must be at least 2mm of 'continuous' tumor tissue. (Basically at least a 2mm clump of tumor tissue.)

2. The cancer must be estrogen positive. (It can be progesterone negative and, though you didn't mention HER2 status, they accept both HER2 positive and negative. [The most common tissue they receive though is from E+, P+, HER2- tumors.]

Also someone elsewhere on MC posted that the "risk of recurrence" number clients receive from an OncotypeDX test precludes the risk of spread from the original tumor. That is incorrect. The 'risk of recurrence within 9 years' applies to "anywhere in the body." But I think there's an assumption that surgery left clean margins. Some tissue submitted to Oncotype is rejected or sent back because misdiagnosed. Including samples from tumors labeled non-invasive which clearly show signs of invasive characteristics in the labs at Oncotype.

My OncotypeDX risk result was 3% (if I took aromatase inhibitors). Which translates to approx. 5.5% risk if I don't. I didn't have radiation. And the low OncotypeDX number ruled out chemo. So the test was very important in my decision(s). I post about these genomic tests so others can nudge their doctors into being conversant with the array and quality differentials of the tests available. Data is data and is all that we have to work with other than physicians' experience and our own knowledge and gut instinct about our own bodies.

I hope this is helpful for you and anyone else able to get this test done if they know about it aforehand.]