Invasive ductal carcinoma (IDC): Anyone else?

I finally received my ONCOType score of 16, which I believe is good. I have Stage 1, IDC and wondered if anyone else has opted to not take radiation or an AromatasevInhibitor. I am 73 and my Radio-oncologist said I could opt out of the radiation or choose 5day course. The Oncologist suggested taking the pill for 5 years. I have a family history of Osteoporosis. I’m afraid to take it, and afraid not to. Please advise or let me know if you opted out. Thank you

There are parameters for the various Oncotype tests, including the OncotypeDX. (The parent company is Exact Sciences.) I mention this in case someone had a cancer that was not submitted for an OncotypeDX and wonders now if the oncologist was remiss in failing to explore that option.

And there are several different tests now available from the company, each with a very specific objective. So when someone mentions 'the Oncotype' test, ask which specific test is being referred to in order to avoid confusion. Or accidentally talking about very different tests.

There is an increasing selection of genomics tests for breast, and other, cancers so expect some new names to ask doctors about too probably. I wish I'd known more about this before my Bad News Biopsy but glad that my oncologist did as the OncotypeDX made treatment decisions simpler.

I had zero positive lymph nodes and had the OncotypeDX. Ditto two friends.

I've not heard of it being specifically recommended for 1-3 positive nodes but 0 positive isn't precluded.

The ONCOTYPE scoring is 0- 100. I had scores of 14 and 20 thus NO CHEMO.

Yes, exactly. Thank you.

@anjalima and @polianad22

Again, Oncotype is done for 1-3 positive nodes and chemo is not assumed.

From the Susan G. Komen site: Oncotype DX helps predict the chance of metastasis and the likelihood of benefit from chemotherapy for early breast cancers that are all of the following [14,32-34]:

Tumor size smaller than 5 cm
ER-positive (and will be treated with hormone therapy)
HER2-negative
Lymph node-negative or 1-3 positive lymph nodes

Good morning. By “surgically rendered tissue” I meant the tumor taken at the time of surgery verses the tissue from the biopsy. My oncologist submitted biopsy tissue for the ONCOTYPING.

My presumption is that your surgeon ( Mt Sinai) will order chemo, if node positive, in any case so why bother with ONCOTYPE ( which may suggest that chemo is not needed). Yes, I’m familiar with KI 67. It is among one of the values considered. I was right at the cusp of where it becomes “aggressive”. It appears in the research that the ONCOTYPE DX is the more relied upon measure. There is research on this. I read every study I could get my internet hands on. Lots of research posted from Canada, England, and other European countries.

I think you are wise to get a second opinion. I did also.

Oncotype is recommended for those with 1-3 nodes positive.

Ki67% is actually one of the proliferative factors included in the Oncotype but there are several. My ki67% was high but my Oncotype was low so I called Genomic Health to ask them. Also I had grade 3 and they told me 30% of grade 3's have low Oncotypes.

Many docs don't order the ki67% because it is considered unreliable. I still wonder if healing biopsy tissue threw mine off.

What does it mean surgically rendered tissue?

My understanding is that Oncotype is done after the surgery. But it make sense to do it before the surgery to see if the tumor is aggressive.

There is another test called Ki 67 proliferation index.

When I asked the surgeon on September 21st about Oncotype and Ki67, she told me that they do it after surgery. Not only, but if she finds positive nodes they don't do Oncotype. Mount Sinai.

Your surgeon or oncologist will make the referral. I had my result before surgery based on my biopsies. In my case they had enough tissue to do the typing.

The oncologist was looking to see my numbers ( aggressive or not so aggressive). Had my numbers been higher she would have suggested chemo before surgery to shrink any nodes to minimize a major axillary removal.

Ask about this on the 13th. Often it’s done with surgically rendered tissue.

🌸