Oncotype DX Test: What does it all mean?

Posted by psd8 @psd8, Jun 1, 2019

I was diagnosed with Stage 2 ductal breast cancer in one breast. Had a bilateral mastectomy. Nodes were clear. Tumor hormone +. Had an Oncotype test scored at 33. Now I’m suppose to have chemo. Anyone else had this test? Any opinions on this?

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Last February I was diagnosed with invasive ductile carcinoma in my left breast. I am 63 years old. The biopsy and the ultrasound revealed my tumor was 1 cm in length and my cancer grade was 2 out of a possible 3. Good news! We were looking to do a lumpectomy. My doctor scheduled a breast image, which revealed tumor to be 1.8 cm and had almost doubled in size. Next a radiologist found precancerous cells in my left breast. I was devastated but made a decision to do a nipple sparing mastectomy. My cancer is not genetic. I was told after my mastectomy no cancer in my lymph nodes, no cancer in my margins. This was great news as I didn’t need radiation nor Chemo. My oncologist then ordered Oncotype DX test to review my tumor. The test came back and my tumor was upgraded from a 2 to a 3. This very aggressive tumor, now requires me to do Chemo. I am stage 1 breast cancer and I am doing chemo.

The reason I am posting this, is that both tests Breast Imaging and Oncotype DX are not always covered by certain insurance policies. These are expensive tests and insurance companies may not cover them. I feel the Oncotype DX test may have saved my life. Most important, please follow your oncologist direction.

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@kilkennyfarmwife

Last February I was diagnosed with invasive ductile carcinoma in my left breast. I am 63 years old. The biopsy and the ultrasound revealed my tumor was 1 cm in length and my cancer grade was 2 out of a possible 3. Good news! We were looking to do a lumpectomy. My doctor scheduled a breast image, which revealed tumor to be 1.8 cm and had almost doubled in size. Next a radiologist found precancerous cells in my left breast. I was devastated but made a decision to do a nipple sparing mastectomy. My cancer is not genetic. I was told after my mastectomy no cancer in my lymph nodes, no cancer in my margins. This was great news as I didn’t need radiation nor Chemo. My oncologist then ordered Oncotype DX test to review my tumor. The test came back and my tumor was upgraded from a 2 to a 3. This very aggressive tumor, now requires me to do Chemo. I am stage 1 breast cancer and I am doing chemo.

The reason I am posting this, is that both tests Breast Imaging and Oncotype DX are not always covered by certain insurance policies. These are expensive tests and insurance companies may not cover them. I feel the Oncotype DX test may have saved my life. Most important, please follow your oncologist direction.

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As you move through this treatment,, please remember we are here for you. I also had chemo for invasive ductal carcinoma. I also had some surgeries, and radiation, and finally some hormone therapies. I was considered very young and my cancer grade was a 3. Oncotype DX did not exist at the time, so I cannot comment to that. I was later (8 years) tested and found to have a genetic predisposition to several cancers. Which my family had already guessed. All of that being said, cancer treatments can be hard, but do able, and worth the life you gain. I am here to support you in any way that I can. Please reach out, and let us know how you are doing.

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@kilkennyfarmwife

Last February I was diagnosed with invasive ductile carcinoma in my left breast. I am 63 years old. The biopsy and the ultrasound revealed my tumor was 1 cm in length and my cancer grade was 2 out of a possible 3. Good news! We were looking to do a lumpectomy. My doctor scheduled a breast image, which revealed tumor to be 1.8 cm and had almost doubled in size. Next a radiologist found precancerous cells in my left breast. I was devastated but made a decision to do a nipple sparing mastectomy. My cancer is not genetic. I was told after my mastectomy no cancer in my lymph nodes, no cancer in my margins. This was great news as I didn’t need radiation nor Chemo. My oncologist then ordered Oncotype DX test to review my tumor. The test came back and my tumor was upgraded from a 2 to a 3. This very aggressive tumor, now requires me to do Chemo. I am stage 1 breast cancer and I am doing chemo.

The reason I am posting this, is that both tests Breast Imaging and Oncotype DX are not always covered by certain insurance policies. These are expensive tests and insurance companies may not cover them. I feel the Oncotype DX test may have saved my life. Most important, please follow your oncologist direction.

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Hi @kilkennyfarmwife, I'd like to add my welcome. Several members have had questions about the Oncotype DX test. I see you've also provided insight to fellow members in this discussion:
– Invasive ductile breast cancer: What should I expect? https://connect.mayoclinic.org/discussion/invasive-ductile-breast-cancer/

When do you start chemo and what regimen are you getting?

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In recent posts, there are references to some tests that were never offered to me when I was first diagnosed four years ago.

While researching, found great site that list all the different screening, diagnosis, and monitoring test used to diagnosis and determine treatment plans for breast cancer.
https://www.breastcancer.org/symptoms/testing/types
According to my oncologist, not all tests are needed in all situations, but definitely worth asking your provider about.

Laurie

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@roch

In recent posts, there are references to some tests that were never offered to me when I was first diagnosed four years ago.

While researching, found great site that list all the different screening, diagnosis, and monitoring test used to diagnosis and determine treatment plans for breast cancer.
https://www.breastcancer.org/symptoms/testing/types
According to my oncologist, not all tests are needed in all situations, but definitely worth asking your provider about.

Laurie

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The Oncotype Dx was offered to me at diagnosis. Five years later I sought out the Breast Cancer Index and Prosigna Assay myself, to help with the decision on doing more years on an aromatase inhibitor. My doctors had never heard of these tests. I also paid nothing after applying for financial aid. We have to take care of ourselves.

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@roch

In recent posts, there are references to some tests that were never offered to me when I was first diagnosed four years ago.

While researching, found great site that list all the different screening, diagnosis, and monitoring test used to diagnosis and determine treatment plans for breast cancer.
https://www.breastcancer.org/symptoms/testing/types
According to my oncologist, not all tests are needed in all situations, but definitely worth asking your provider about.

Laurie

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Thank you for this information.

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@roch

In recent posts, there are references to some tests that were never offered to me when I was first diagnosed four years ago.

While researching, found great site that list all the different screening, diagnosis, and monitoring test used to diagnosis and determine treatment plans for breast cancer.
https://www.breastcancer.org/symptoms/testing/types
According to my oncologist, not all tests are needed in all situations, but definitely worth asking your provider about.

Laurie

Jump to this post

My oncologist ordered a MammaPrint when I was first diagnosed and had my biopsy. I didn’t know about all the tests then. The results of my MammaPrint indicated that I was low risk for reoccurrence. It indicated that there was a less than 1% chance of chemo being beneficial. I liked that the results helped dictate my treatment plan. One thing that has confused me is that my KI-67 was 49% on my pathology report but my MammaPrint showed low risk. Has anyone had scores like this?

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@kammcn

My oncologist ordered a MammaPrint when I was first diagnosed and had my biopsy. I didn’t know about all the tests then. The results of my MammaPrint indicated that I was low risk for reoccurrence. It indicated that there was a less than 1% chance of chemo being beneficial. I liked that the results helped dictate my treatment plan. One thing that has confused me is that my KI-67 was 49% on my pathology report but my MammaPrint showed low risk. Has anyone had scores like this?

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I was grade 3, lymphovascular invasion and highish KI-67 at 20%. Oncotype people told me that KI67% is only one part of their evaluation of proliferation factors (I can't remember but there were 5-7). Doctors don't find Ki-67 that reliable. I have wondered if the healing from my biopsy threw it off. You can call MammaPrint and I am sure they will reassure you.

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@roch

In recent posts, there are references to some tests that were never offered to me when I was first diagnosed four years ago.

While researching, found great site that list all the different screening, diagnosis, and monitoring test used to diagnosis and determine treatment plans for breast cancer.
https://www.breastcancer.org/symptoms/testing/types
According to my oncologist, not all tests are needed in all situations, but definitely worth asking your provider about.

Laurie

Jump to this post

My Oncotype Dx was 22 – showing that chemo would not improve my odds of reoccurrence, So I skipped chemo & just had the lumpectomy and radiation. I was not told about KI67.

REPLY
@roch

In recent posts, there are references to some tests that were never offered to me when I was first diagnosed four years ago.

While researching, found great site that list all the different screening, diagnosis, and monitoring test used to diagnosis and determine treatment plans for breast cancer.
https://www.breastcancer.org/symptoms/testing/types
According to my oncologist, not all tests are needed in all situations, but definitely worth asking your provider about.

Laurie

Jump to this post

I had the Mammaprint test. It said less than 1-5% chance of returning in 10 yrs, no chemo needed and a Ki of 34%. I had metastatic to the bones in 1.5 years. I am not a believer in that test. Money wasted imo.

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