Oncotype, MammaPrint, etc.

Oncotype
My MO didn't even tell me about the oncotype test. She was already to give me chemo. I found out about it on my own and asked to have it done. It saved me from having unnecessary chemo. I fired my MO because of this and other reasons as well. The test is $4,200. My insurance paid $3,800 and I wasn't charged anything. You don't qualify for the test if you have lymph node involvement and are pre-menopausal. If you've already started treatment (and by your join date, I assume you've been through treatment) insurance may not cover it "just to find out".

I've only heard about the MammaPrint recently. From what I understand, they have to do the test right away on your tumor. You can't have it done later.

It's too bad your MO wouldn't explain more as to why you couldn't have it done. If you qualified, it's a shame. Maybe you didn't qualify, but he should have told you. I found you really have to advocate for yourself going through this. I probably don't do it enough, but I'm getting better

As far as the gene predictor test (I take it you're referring to the BRAC gene tests). I was told they didn't think mine was hereditary and didn't need to take the test. It's also about $4K. Others on this board probably have a lot more information about this test than I do.

I can understand why you'd want to know your score-just because. The more information we have, the easier it is to deal with this. Hope you get the answers you want.



Deb

kacee999 said:

Oncotype DX
I was Stage 1. I am 60. My MO definitely wanted the Oncotype before we settled on a game plan. My cancer was aggressive, but fairly contained. My sentinel lymph node was positive, but microscopic. I could have opted for just radiation. My Oncotype score was 38 (off the boards high). That cinched it. That definitely swayed him to include the chemo. Rough as it was, I'm glad I did it. Hoping that chemo and rads will be the one-two punch that keeps that **** away. I am also on Arimidex for 5 years. Whatever it takes. I'm in it for the long haul.

Why do you feel you should have one?
The oncotype test (as I understand it) is to help determine whether chemotherapy might be beneficial or not in early stage, hormone receptor positive breast cancers. The deal is why go through the risks of chemotherapy if your score indicates you have a minimal chance of recurrence with hormone therapy alone? All the data (and hence the scoring) is based on outcomes of women who were early stage AND estrogen receptor positive. It is not based on higher stage, ER- cancers, so it would be meaningless for someone who fits that criteria to have the oncotype test. They know to treat ER+ cancers with tamoxifen or an aromotase inhibitor and the data for the oncotype test assumes you will be taking one of those drugs. It's whether to add chemotherapy or not. If your score is high, it means that more women with the same results (who were in the study) developed distant metastasis within 10 years while being on hormone therapy alone. Chemotherapy reduces that risk of recurrence (but doesn't eliminate it).

If you had positive nodes, they know from the get go that the cancer was not confined to the breast. Chemotherapy is systemic, so it's worth the risk in order to have something in addition to hormone therapy to seek and destroy breast cancer that might be elsewhere. The hormone therapy will not allow the cancer to have estrogen to grow, and hopefully it will wither and die because it can't reproduce, but the chemotherapy will hopefully kill them outright and then the estrogen therapy will supplement that for any cell that was smarter than the chemo.

So, if you fit the criteria for oncotype test, and your doc just thinks s/he is smarter, I'm sure you could have it done, but you may have to pay for it. If you don't fit the criteria, I don't know what value it would be to you and whether you could convince someone to order it. When I was diagnosed 2 1/2 years ago, I was told that not all insurances would cover it (I think they all do now) and I might have to decide whether I would want to pay for the test. Luckily, my insurance covered it, and the results were valuable. My score was high - I had chemo.

It is pretty well accepted (I was told by my oncologist) that many breast cancers are over treated and women go on to live full lives just to develop long term side effects from chemotherapy that wasn't necessary. I had chemo 2+ years ago. I still don't have very much hair and I hate it and I hate the stupid chemo. But I'd rather be on this side of the grass than have a full head of hair and be dead. No regrets here.

I know nothing about the mammoprint test.

Good luck. Hope you can sort through this and get the test if indicated.

Suzanne