Oncotype DX for Breast Cancer Explained

[@amyl5764]

My Oncotype DX score was a 6, which informed my medical oncology team that I would not receive a benefit from chemo so I didn’t have to do chemo (yay) but that score plus all the tumor pathology reports also made me a candidate for accelerated partial breast irradiation (APBI) so I only had to have 5 radiation treatments rather than the 4 weeks. That too was a great outcome from the Oncotype DX results. Now it’s Anastrozole for the next 5 years, and then we will see what’s next after that!

[@yerbba]

It's wonderful to hear how the Oncotype DX test provided such valuable insights for your treatment plan, leading to a path without the need for chemotherapy and a more focused radiation approach. It is the goal of cancer clinicians to give less rather than more. So happy to hear you've benefitted from "de-escalation."

[@tacitusromanus8239]

I had the Oncotype DX test done and scored a 13 on it. I was so relieved not to have to undergo chemo though I was hyped up psychologically to do it if medically necessary. I think it is a very important test to ask your chemo doctor to order for you. I just had to do 30 days of radiation. Thanks to all the wonderful medical folk who helped me in CA and now in OR on my cancer journey.

[@yerbba]

Thank you for sharing your experience with Oncotype DX testing. It's indeed a valuable test that helps tailor treatment plans based on individual circumstances. Thank you for watching!

[@ColorWhims]

Thank you for explaining the oncotype DX. I didn’t have it done even though it was encouraged by my oncologist and surgeon. My diagnosis was HER2- estro+ pro neu. Grade 1 and 2. Took genetic testing and no braca 1 and 2 gene. Stage 2 cancer. I am on anastrozole. It was my choice and I feel comfortable with the choice I made. My health care team are amazing people in Honolulu, Hawaii!

[@yerbba]

We're so glad you found this video helpful and appreciate you for sharing your experience with the Yerbba community!

[@maryellenrichardson9419]

I scored a 35 and received chemotherapy. My oncologist explained this to me but not as clearly as you just did. Thank you for your informational videos.

[@yerbba]

We're glad to hear that our video provided a more detailed explanation for you! Thank you for watching.

[@buzz_chill]

Hi @maryellenrichardson9419. I just recently scored 36. May I please ask how many weeks of chemotherapy was required of you, I hope you don't mind me asking. Just anxious.

[@maryellenrichardson9419]

@@buzz_chill I received chemo one day a week every third week for a total of 4 (4/12, 5/3, 5/24, 6/15) then 3 weeks later I started 20 days of radiation.

[@debbiegiangrandi4672]

You are wonderful and helped me so much through my cancer journey god bless you !

[@yerbba]

Thank you for your kind words! It's truly heartwarming to hear this. Wishing you continued strength and wellness on your journey.

[@lilybaide2239]

can you please make a video on radiation after a luptoctomy please

[@yorkiepeachygirlllc761]

Your videos are always calming and so informative-Thank you so much as I begin my journey.

[@yerbba]

Your support means a lot to us! Thank you for watching and being part of the Yerbba community.

[@lailaat6020]

Hi im 50 years old i have a lobular breast cancer 6cmx5cmx5cm er and pr at 95% ki67 at 10% her2 at 0 i have done a mastectomy and one sentinel lymph node removed showed micromets my oncotype is a 10 and i dont need chemotherapy now i undergo 25 sceances of radiotherapy then hormontherapy

[@yerbba]

Thank you for reaching out with your question. Managing lobular breast cancer requires careful consideration of various treatment options. It's hard to determine your treatment plan without knowing the unique characteristics of your tumor, pre-existing conditions, and overall health. If you're based in the U.S., visit yerbba.com to access your Yerbba report with personalized treatment options. This resource is designed to help you understand your treatment options in a comprehensive and detailed report. We're here to empower you with information to make confident decisions about your care.

[@jennfischetto]

I scored 38, so I'm currently on week 5 out of 20 weeks of chemo. I'm not thrilled, lol, but I'd rather a 10% chance of recurrence over 26% without chemo. Grateful I had the test done. Thanks for discussing this.

[@yerbba]

We appreciate you sharing your experience. Sounds like the results of the OncotypeDX assay were super helpful in your case. Thank you for watching.

[@sharmilamunusami4603]

Hello I scored a 36 and I am about to start chemo. If you don't mind me asking how was chemo. I am a little scared of what to expect.

[@2joie]

Mine was high. I underwent chemotherapy and I am a cancer free amateur natural body builder 9 years later. You got this :)

[@jennfischetto]

@@2joie Thank you! ❤

[@jennfischetto]

@@sharmilamunusami4603 I'm sorry I didn't get a notification for your comment. I assume you now know, but for me, it went okay on the first drug and not so great on the second. I had to have two because I had a reaction to the first suggested treatment. Anyway, I hope it wasn't to bad for you. ❤

[@jimmiepatrum]

This video was very helpful. I had a bilateral mastectomy four weeks ago and am awaiting results of the oncotypedx test. I am ER and PR positive and HER2 negative, high grade. The radiologist expects the results to come back high - maybe 60 or 70. I pray that he's wrong, but if not, then I will be undergoing chemo, then radiation, then hormone therapy. Thank you for all you do to help breast cancer patients understand various tests and treatments. Diane

[@yerbba]

Thanks for taking the time to write. Wishing you the best as your treatment moves forward.

[@stchannel2476]

I kept hearing about this test. Thank you for explaining it.

[@yerbba]

Thank you for watching. We're glad it provided helpful information about the Oncotype DX test.

[@naththomas9946]

Thank you, Dr. Griggs, for your informative medical information on breast cancer (health) and awareness.

[@yerbba]

Thank you for watching. We appreciate your support!

[@notaz123]

Hi Dr Jenn.kindly give more info of breast cancer stages eg 2A,2B etc

[@yerbba]

Check out our video on the treatment of Stage II (2) breast cancer: kzbin.info/www/bejne/qoO2daONaL-fm8U.

[@calb1231]

Why do you get the test results after you’ve already had surgery? I had a lumpectomy after dx. After surgery the test came back showing an Oncotype score of 32. So, I then had chemo and radiation. My thoughts are IF I knew before the lumpectomy that I had a high oncotype score I might have opted for mastectomy.

[@same5952]

You probably get results after the surgery because the test is performed on the tumor itself which would have to be removed first before being tested. That's my understanding anyway.

[@calb1231]

@@same5952 I probably don’t understand the biology part. When they did the biopsy that showed cancer is that sample not large enough to be tested also to give the oncotype score? It’s just that now I know I have a high oncotype score and would have felt better to have had the mastectomy instead of just the lumpectomy. 🤷🏻‍♀️

[@LindaLopez-i3r]

My surgeon told me that exactly. The biopsy isn’t a large enough sample for an Oncotype test.

[@yerbba]

The OncotypeDX test is not done in people with more than 3 positive nodes. So surgery has to be done to see what stage the cancer is. For our other viewers, the OncotypeDX test is not (yet) used to make prognostication or treatment decisions about surgery in invasive breast cancer.

[@AdrienneKushner-qi6cl]

My doctor sent the biopsy for the oncotype test. I had a bilateral mastectomy and then waited for the results. When my doctor finally called with the results, I was elated to score 13. No chemo and no radiation for me.

[@L-ash777]

Are you referring to staging under the latest AJCC 2018, (American Joint Cancer Committee) because originally I was staged at 2B, however under the AJCC 2018 I was 1A

[@yerbba]

Yes, we are using the AJCC 2018 staging system.

[@Red_Flower81]

Hello dr. Jennifer , interesting video as always…I have a question I hope you could answer: what is your opinion on integrative treatments such as high doses of vitamin C, mistletoe or melatonin…do they work well in synergy with traditional treatment as far as improve the patient conditions? Thank you very much in advance.

[@yerbba]

In general, these treatments have not been tested. They are supported with anecdotes. While people's stories are important, it is difficult to recommend anything that has not been rigorously tested.

[@StellaSchmitz-o2d]

Can the Oncotype DX test be used for someone with a macromet in the sentinel lymph node?

[@yerbba]

Yes, this test is available to people with 1 to 3 positive nodes as long as the tumor is ER-positive and HER2-negative.

[@jenna5986]

What does invasive ductal carcinoma with mucinous differentiation mean on my pathology report? And would this effect my oncotype score?

[@yerbba]

Thanks for the question. Your cancer is different from mucinous cancer. There have not been any studies of the impact of mucinous differentiation on the OncotypeDX assay results.

[@shantazellner852]

If you have positive lymph nodes , but have a low oncotype score what needs to be the choice of treatment

[@yerbba]

Good question. If there are 1 to 3 positive lymph nodes, a low OncotypeDX score may lead your medical team to offer endocrine therapy alone and not chemotherapy.

[@user-fm5bd4hp3n]

Hi whats relationship with ks67 score?

[@yerbba]

Ki-67 is part of the OncotypeDX panel. On its own, Ki-67 is a biomarker that provides insight into how quickly cells are dividing, which can offer some information on tumor growth. However, all by itself, it’s not considered the most reliable predictor for treatment effectiveness because of variation in interpretation from lab to lab. Additionally, there isn’t a universally accepted cutoff point for defining low versus high levels, so it's often used as just one piece of a bigger diagnostic picture. Stay tuned for our upcoming video that addresses this topic.

[@briggettecammett6181]

Could u speak on mucinous breast cancer?

[@yerbba]

Mucinous cancer is different from other breast cancers with respect to the OncotypeDX. The OncotypeDX scores are not validated in people with mucinous carcinoma, and despite the much better prognosis, the OncotypeDX scores are high! This can be confusing, and the test should not be done in people with mucinous carcinoma.

[@briggettecammett6181]

@@yerbba why?

[@briggettecammett6181]

@@yerbba my oncotype score was 10 with a mucinous ca dx.

[@briggettecammett6181]

Is mammaprint better testing for mucinous breast cancer?

[@jenna5986]

​@yerbba my pathology report says histology: invasive carcinoma with features of mucinous carcinoma. I have grade 2 Er and pr positive and her 2 negative. Tubule : 3, Nuclear pleomorphism:3, Mitotic rate 1. My oncotype score came back high at a 37. Could this mucinous component make my score high or would it have no effect on this score? Thank you!

[@HIB2016]

Excellent video! ✨️

[@yerbba]

Thanks for watching! We're glad you found this video helpful.

[@StellaSchmitz-o2d]

Is the Oncotype DX test valid for mixed IDC/ILC tumors?

[@yerbba]

Yes, it appears to be. In that case, the tumor is generally treated as IDC.

[@shannonharris9781]

I am postmenopausal, recurrence score was 21 with a 7% recurrence rate within 9 years.The cutoff was 25 for chemo so I only have to take an aromatase inhibitor. With the score being closer to the 25, would you think that staying on the AI for additional years after the 5 yr mark would be beneficial? Thank you.

[@yerbba]

Great question. The cutoffs that are used are more helpful for estimating the benefit of chemotherapy (if any) rather than identifying whether or not 10 years of endocrine therapy is warranted. It may be that tamoxifen is offered for a couple of years up to a full 10 years total so that you get some benefit to your bones and liver from tamoxifen. These are all things to talk about with your medical team.

[@shenanigans8799]

My Oncotype DX came back at 46%. I did 4 rounds of TC and 30 rads, after DMX.

[@yerbba]

Thank you for sharing your story here with the community. Wishing you the best.

[@Maggie-rj8iz]

Your videos are so appreciated Than you so much

[@yerbba]

Thank you for the kind words and being part of the Yerbba community. We appreciate your support!

[@lindafarrarv1142]

Are there. Any new tx for inflammatory breast cancer

[@yerbba]

There are a lot of treatments for inflammatory breast cancer that depend primarily on the tumor characteristics, such as hormone receptor and HER2 status as well as other more specialized markers in people with advanced disease.

[@carolbraswell4488]

My surgeon refused to do a OncoType. I'm triple positive grade 2 stage 1. I have never understood why she did that. I'm postmenopausal. Do doctors refuse to do these test??

[@mrking695]

I could be wrong but I think the test doesn’t work on HER2 positive, only HER2 negative. Mammaprint works in both so I’m told. But Dr Griggs would be the expert on that.

[@jennfischetto]

This video says the test is done when your HER2 is negative, not positive. That's likely why, but you should be able to discuss it with your surgeon. Good luck!

[@LindaLopez-i3r]

For Triple positive breast cancer, chemotherapy is the standard of care. Oncotype is used in the case of ER +/HER 2 - to evaluate whether chemotherapy will be effective.

[@yerbba]

In people whose tumors are triple positive (ER, PR, and HER2 positive), the OncotypeDX assay results will always be high. Our video explains that the test can only be done in people whose tumors are HER2-negative.

[@LFrandomvids]

hello and thank you for your videos. I had the Oncotype DX test and scored low (2%) which meant I did not take chemotherapy. These results were also used, after surgery and radiation, to recommend getting off AI after a year because of overwhelming side effects. Should I also have a Breast Cancer Index test to tell if staying off AI is the best choice? Thank you for your thoughts.

[@yerbba]

The Breast Cancer Index is helpful in decided whether people will benefit from extended endocrine therapy, that is, will they benefit from a total of 10 years of endocrine therapy. It's not used to decide which endocrine therapy.

[@JR-kz2xn]

Can they do this test on someone who has had a pCR at time of surgery as there is no tumor so to speak. Assuming you had neoadjuvant chemo. Or is this something that would be done at biopsy time? Thank you...

[@yerbba]

In someone who has had a pathologic complete response to chemotherapy, there would not be much value of the OncotypeDX assay. The benefit of the assay is in identifying people who will benefit from chemotherapy (+/- targeted therapy), which clearly you did, and in estimating prognosis. Having had a complete pathologic response is excellent prognostic information.

[@deborahbizzell1989]

My Dr.never revealed my onco score to me,but does not want to give me chemotherapy.Stage 3,grade 2 with 2 cm.tumor under my armpit.

[@yerbba]

It’s understandable to want to know your Oncotype score, as it helps guide treatment decisions. The information on the report is very helpful in understanding the test results, and your doctor will most likely give you a copy if you ask. Since your doctor isn’t recommending chemotherapy, it may be based on factors like your tumor’s specific biology or overall health. We'd suggest asking your medical team to explain the reasoning behind your treatment plan.

[@LindaLopez-i3r]

Very useful topic! I valued the input from my Oncotype test. It was a bit stressful to wait after surgery to get the results in order to make the chemo decision but understand the need to test the tumor. My result was below what would recommend chemo post menopausal. It showed

[@yerbba]

The recurrence score is extremely accurate. Recall that tumor biology (personality, which the OncotypeDX test helps define) is as important as stage.

[@meghnakatkamwar7176]

Hi ,my mom also has 1 positive node(5mm) and aome doctors recommended Oncotype Dx whereas some said chemo is for sure needed as one node is positive, whats your view on this and if you dont mind sharing ,what did you end up deciding?

[@mrking695]

What do you think of 70 gene mammaprint? That’s what I received. Luckily mine came back ultra low risk. I don’t hear much about Mammaprint.

[@yerbba]

Mammaprint is another assay that is used in many practices. We'll do a video on the other genomic assays soon.

[@mrking695]

@@yerbba thank you!

[@wendybinderow2273]

2.7 cm invasive ductal carcinoma right breast. 1 positive lymph node. PERI-menopausal with FSH @ 6.6 and Estradiol @ 443. Oncotype score @ 19. I'm worried b/c I am NOT post-menopausal so is my score low-enough to forgo Chemotherapy?

[@yerbba]

You're in that in-between spot. Talk your choices over with your oncologist because at this point, your preferences will shape the type of treatment you are offered.

[@valentinalidano2949]

I am postmenopausal with 18 recurrence score. Could I figure out what the rate is, in percentage? Sorry for bad english...

[@yerbba]

With a recurrence score of 18 and being postmenopausal, your risk of recurrence is generally considered low to intermediate. The OncotypeDX report will have an estimated risk of recurrence. It's possible that you were not given all 3 pages of the report. It’s best to discuss it with your doctor for more personalized information.

[@valentinalidano2949]

@@yerbba thank you for your answer. I haven't seen the report at all, they only told me the result was 18. I thougt it was a low risk and wanderd why they decided to treat me with abemaciclib...

[@marykleanthous30]

Is it possible to request this test 6 months after a mastectomy if the tumour has been stored in pathology. In UK I believe the tumor samples are sent to the USA. I was not offered this here after a mastectomy (second primary) in same breast Stage 2 grade 1 no lymph involvement but feel on all evidence it may be worth it ? Papilliary solid invasive 7mm

[@yerbba]

Great question. Papillary cancers have a low risk of recurrence. The OncotypeDX test is not used in this type of cancer because chemotherapy is known not to benefit the vast majority of people.

[@francisrodriguez2119]

My diagnosis was High Grade Ductal Carcinoma Insitu & Invasive Breast Cancer Stage 1A tumor size 1/4 of a centimeter but contained the deadliest of cells which brought the Evasive breast cancer diagnosis. Oncodox score 37 BRCA2 gene mutation discovered at 50 yrs old Also Pagets Disease of nipple PR-, HER2 -, ESTROGEN LOW POSITIVE 5% Treatment done Double Masectomy Ovaries & Tubes removed 6 Rounds TC Chemo Now on 3 rd aromatese inhibitor Because first two were intolerable with all these why are estrogen blockers needed if mine was only 5% estrogen ? I understand that my cancer type the low estrogen breast cancer is least studied but what is known is it tends to respond as triple negative . I’m having such hard time with aromatese inhibitors I just want to know risks if I stop them ?

[@yerbba]

Thanks for writing. You've been through a lot. With a low level of estrogen receptors, you are correct. The benefit of anti-estrogen therapy is very low. Talking over your experience with your medical team and expressing your desire to stop your endocrine therapy is a good first step.

[@Chirag-i1j]

Thank You So much for the video, also please let us know how accurate are these tests. Also for the viewers from India, there's a homegrown test called CaNAssist, can we also get some more information about that if possible like the accuracy and success rates of these tests. Thanks

[@yerbba]

The OncotypeDX test is extremely accurate. Exceptions are if the tumor is widely heterogeneous, having different characteristics throughout. We are not familiar with the homegrown test in India. We can definitely do a video on such tests and other genomic assays. Thanks for writing!

[@Chirag-i1j]

@@yerbba Thanks for the reply :)

[@mctaylor8465]

When did oncotype dx testing become available? And why does stage 3 er+pr+her2- not qualify for this testing ?(i thought Dr. Griggs indicated it was only done for Stage 1 and 2) I'm just interested if it was available in 2010 and I was not informed regarding its availability.

[@yerbba]

Oncotype DX testing became available in the mid-2000s and was in more widespread use in approximately 2008 for people with 1 to 3 positive lymph nodes. It’s used for early-stage breast cancer (stages I and III) and not for stage III because the risk of omitting chemotherapy in people with Stage III cancer high enough that consideration of omitting chemotherapy is not at play.