Connect
Invasive ductal carcinoma (IDC): Anyone else?
I have rec’d 4 chemo + 16 radiation treatments for invasive. Has lumpectomie 1st....then one week later...
Dissection 17 lymph nodes & 3 tumors removed tumors
Got clean margin.
Like
Helpful
HugInterested in more discussions like this? Go to the Breast Cancer Support Group.
Connect
I’m sorry that this is something you must go through… as we, in this group, all have. It’s a traumatic experience to be told what we have been told!
I think you are definitely on the right track to get a second opinion about treatment options. MSK is a good place to get that. Mount Sinai is also a great option.
Best of luck on the 13th. Warm hugs 🌸
Thank you.
When do I have to schedule the Oncotype DX test ?
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.
🌸
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.
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.
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.
@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
Yes, exactly. Thank you.
The ONCOTYPE scoring is 0- 100. I had scores of 14 and 20 thus NO CHEMO.
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.