Topic: Any Her2+ With Low Onco Type DX Score?

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Anyone?

Pam,

I dont know if this will help but my info is:

IDC, 2.4 cm, node negative, Stage 2, Grade 1....her2 negative.....onco score 12...

I had lumpectomy w/snb and 37 rads...now on tamoxifen.

And doing wonderfully. I had my 6 month followups last week and was told I am NED :)

Jule

Thanks Dejaboo. i guess i don't qualify for an onco score now that my node turned out to be positive (the pathologist screwed up!) Is that a chocolate lab in your picture?

Hi Magentagirl- I may be wrong...But I almost think they are just starting to do an Oncotest for Node Positive....Or will be.  I think I read that somewhere.  Didnt pay alot of attention.  You could search or post the question.    Sorry to hear your Node came back Positive.

 My Avatar is  a Flat Coated Retriever.

Swimangel-I wonder if your Onco said it was low because he felt it was low.  But then when the Her2 came back he decided with that added the # now felt Higher to him  ?  So he interepreted it different after he had all the info in.

My thoughts exactly Dejaboo.....but I don't really like that kind of "subjective" interpretation. I would have preferred if my onc told me the real numbers from the Oncotype DX and then explained to me about the "gray" area - instead of just saying my score was "low". This is why I really want to see the report - his office said they'll mail it to me today. It won't change my mind about my treatment.....but at least I'll know what the official report said.

What is your onc recommending Dejaboo? If you are pre-menopausal, will you go on any anti-estrogen hormone drugs?

Good luck tomorrow Christianne - I know that dreaded feeling.....here's hoping you get a low score!

Thanks for the good luck wishes.

Ok, I got my Onco results today.  My oncotype score was 20, which is in the bottom of the intermediate range.  My oncologist said my risk for recurrence in the next 10 years is 12% and that chemo would only reduce my risk to 9%.  He didn't think it was worth it.  Another way to say this is that 97 out of 100 women would do no better with chemo and only 3 would benefit.  And my doctor felt that the side effects and risks of chemo would outweigh that 3%.  So even with a high Her-2 score, which he said is factored into the oncotype test, I didn't get a high risk score back.  I was very, very relieved--I totally expected to be in the high risk range.  I will start Tamoxifen and be closely monitored.

Swimangel (and Dejaboo, and others), I don't normally hang out on this thread since I'm not HER2+, but I saw your question about your HER2 report and your Oncotype score:

"...is it possible to be Her2+ and have a low Oncotype DX score? And must one have a Fish test done BEFORE getting the Oncotype DX results? Or does the company that conducts the Oncotype DX perform their own pathology testing on the tumor, including the FISH?"

Yes, it is mathematically possible to be HER2+ and have a low Oncotype score.  The formula for the Oncotype recurrence score contains weighted results of tests for the expression of genes in 7 different "gene groups".  Results from 4 of those gene groups add to the recurrence score; results from 3 other groups subtract from it.  HER2 is in one of the groups that increases the score, but so are other genes like Ki-67.  ER and PR are in a group that subtracts from the score.

So, it's all very complicated; but theoretically, even if the HER2 result was positive, it could be counterbalanced by high numbers in the "subtractive" groups or low numbers in the other "additive" groups.

And, no, it is not necessary to have a HER2 test result before the samples are sent for Oncotype testing.  It's my understanding that only the size of the tumor, a positive result for ER, and negative nodal status, are necessary.  Nodal status may be changing, but our insurance companies are not even keeping up with reimbursement for testing on node-negative tumors.

Genomic Health does test the tissue for HER2 as a part of Oncotype testing, but they don't include those results with their report.  They only include the Oncotype recurrence score and the ER and PR results.  You should be able to get a copy of the actual test report--it's part of your medical record, and it includes an interpretation of the results.  There is also lots of stuff available on-line, including on the Genomic Health website, that explains the test and its interpretation.

otter 

Thats right Christianne,  I forgot thats how it is done.  Ok- thanks!

Your avatar is so relaxing.  I wish I was there