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Aromatase Inhibitors: Did you decide to go on them or not?
Breast Cancer | Last Active: May 12, 2023 | Replies (1190)Comment receiving replies
@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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I didn't imply that you were making anything up. If you got that impression, it is regrettable but it most assuredly wasn't intended. All I know is what I was told by Exact Science last year.
When I was making treatment decisions in the fall of 2021, and trying to understand the statistics behind some of the numbers showing up in research papers, I did question the Oncotype people a lot to make sure I really understood what I could infer from my test result. [I also wanted to know what I could not infer from it, e.g., recurrence v. "spread."]
As we know making sense of a lot of the stuff gets tricky because of the nature of the statistics from which the algorithm derives information. And there are varying usages of the word recurrence as well to make things even more confusing. I feel such compassion for people with a first cancer diagnosis and entering a strange world where even the language is hard to understand while still having to be the best medical advocate for oneself possible.