Thank you so much for the information. Your summation of the issue is well stated. The information you provided was my understanding but without some of the details. I am HER2 negative. The one thing I didn't know is the necessity for a 2mm piece of continuous tissue, which is why the one lab is telling my doctors there wasn't enough tissue to perform the test prior to aromatase inhibition therapy. I think I need to double-check that both labs evaluate two different sets of biopsies on 5 tumours total. I started on letrozole after both biopsies and 5 weeks prior to surgery for a double mastectomy and lymph dissection. All 4 lymph nodes were negative 🙂 It is unclear whether the doctors understood they were done at different facilities/labs. It also sounds like a specific order needs to be in place to ensure a large enough sample is biopsied for the purpose of this important test.

It seems I have no options regarding getting this test done in some form. I will not accept my Oncologist's plan to wait until possible metastasis. I plan to get 2nd and 3rd oncologist opinions if necessary. My other goal is to share this so as to prevent others from this catch-22. Although I am not looking to finger point and will not, I think the companies' reps doing the ONCOTYPE DX need to educate the surgical and medical oncologist as well as the doctors ordering the initial biopsy such as the obstetrician/gynaecologist. The latest studies are showing promising data on starting endocrine therapy prior to surgery in certain cases. Doctors need to understand these timing issues. I'm concerned and sad I may need to move forward without a clear prognosis, not what I expected. I thank you for your time and interest in this subject. I promise to post any further information I find. Wishing you all well on your BC journeys. Hugs, Randy