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Aromatase Inhibitors: Did you decide to go on them or not?

Breast Cancer | Last Active: May 12, 2023 | Replies (1190)
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@callalloo

Exact Science developed, owns, markets and processes the OncotypeDX test. Genomic Health has nothing to do with the OncotypeDX as far as I know. But at any rate, I again spoke with Exact Science yesterday and they will get back to me with the correct numbers but reconfirm that it is not true that "30% of people with a grade 3 breast cancer get a low OncotypeDX" score.

I would add the caveat that the word low is open to interpretation and I don't know what actual quantitative value Genomic Health would consider "low." My concern is that such a result would be so unusual that it would almost encourage an jnference that the OncotypeDX is a sloppy model and discountable or unreliable.

But imagine having a grade 3 cancer and an OncotypeDX test of the tumor sample showing a very low risk of recurrence. That would be welcome news for a lot of people if, and only if, the test's protocol and model have been thoroughly examined and critiqued and found to have integrity.

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Replies to "Exact Science developed, owns, markets and processes the OncotypeDX test. Genomic Health has nothing to do..."
windyshores | @windyshores | May 11, 2023

@callalloo Genomic Health was acquired by Exact Science. I had breast cancer in 2014 when Genomic Health told me that 30 % of grade 3's had low oncotypes. There were clear definitions of low, intermediate and high.

The reason they told me this is that I had a grade 3, high ki67% (just over the line of high) and lymphovascular invasion. I also had had a positive HER2, two equivocals and two negatives with FISH. Highly ER and PR+. My Oncotype was 8.

It is easy to see why I called Genomic Health,

I was troubled by these contradictions and by the complete and utter reliance on Oncotype by my doctors, including the tumor board at a major cancer center.

Genomic Health told me that this discordance was not uncommon.

Rather than causing us to question the accuracy of the Oncotype, I think that this kind of situation proves its usefulness. With my pathology I would have had chemo for sure (and at first, Herceptin). I am 8 years out so it seems so far the Oncotype was right.

Again, I do not make things up. It is possible that stats have changed in 8 years. But the point remains: genomic testing is better than traditional pathology, with discordance. But ideally they agree. Patients like me need to make decisions and with grade 3, I went with the low Oncotype.

ps My 4th opinion doctor did a retest of the Oncotype and I got the exact same score.

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