Mammaprint-who has had one?
Just curious if anyone has used this test as oppose to the onco test? What was your result? Did it affect your decision on treatment.
Thanks, I just ordered mine. Waiting.
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Hi LizabethM,
My oncologist used a Mammoprint. It only has low or high risk results. Mine came back Low risk. He said I wouldn't receive any additional treatment benefits from chemotherapy. It took 7 days for the results to come in. Good luck, I hope yours comes back Low Risk.
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Thank you for sharing your results! And, I'm glad your result took only seven days as I heard it could take up to two weeks.
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I didn't even realize my MO had sent my tissue out for a MammaPrint. I also came back low risk so I didn't have chemo.
M
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Yes, I had one. My Onc said she preferred it to Oncotype. And since that time, it has been added to the standards of care for the ASCO.
It came back as low risk luminal A. That meant, even though I had one positive axillary lymph node, we decided to not pursue chemotherapy because that would have added only 2% to the long term survival. So instead of 95% it dropped to 93% (or something like that.) I hope it was the right choice, I had a family member just have a metastatic recurrence after 17 years NED from the same type of breast cancer. But we are trying to predict the future and that's so hard when we are not at all in control of it.
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Thank you, Ladies, for sharing your experiences!
I am hoping to have my mamma print back the end of this week so we can plan treatment,
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I had one and it took close to a month to get results. That was thanks to my insurance, which decided I didn’t need it (I am going to fight that!) I was so frustrated and mad and scared it was all I could do not to call the doctor daily after the first week. In the end I was low risk and my MO said that chemo wouldn’t need to be done since I was so low risk. I’m on Tamoxifen now. I was so relieved to get the results back that I was rather shocked when I got my treatment plan.
So if it takes a little longer than you expect, try not to panic.
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Thank you! I will be relieved when I finally have all the pieces of this bc puzzle. The mamma print will help with that! But, the waiting really is difficult.
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Has anyone had a high risk score on Oncotype and low risk on Mammaprint? I got a 35 on Oncotype but my MO didn't order a Mammaprint. I wish I would have insisted on it to compare. I'm stage 1, grade 2 IDC 100% estrogen positive, clear margins, no lymph node involvement and had bilateral mastectomy with reconstruction in July. Going through chemo (AC+T) now but dreading the next few months of this treatment. I want to do everything to reduce my risk of recurrence but concerned of the long term side effects of chemo on my body, not to mention dealing with the current side effects.
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I had both mammaprint and oncotype done. Oncotype was 23, which is middle of the road, but my mammaprint came back in the high risk category, so I am glad I got it tested. It definitely helped finalize the decision to get chemo!
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Just updating this in case anyone searches "mamma print" testing. Mine came back as "high risk" so I am currently doing the chemo that I had hoped to avoid. But, I am grateful for doing the Mammaprint because it helped solidify our treatment moving forward.
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This topic is timely for me so I thought I'd share my experience. I just received my Oncotype DX result of 18, low end of intermediate risk. Oncologist stated I didn't need chemo because my result was less than 24. That appears to be his personal cut off point. But I was still concerned and pressed him on “why 24?" I was also concerned about my risk since my Mom battled breast cancer and died from it. He's not very empathetic with my concerns and brushed them off. But he did say I could have chemo if I wanted it. Who the heck WANTS it! I was going to get another opinion when he raised the option of ordering the MammoPrint test. That seemed like a fair and objective solution since the result is either Low Risk or High Risk. My husband was with me and he agreed so now we wait again for the result. This is so stressful.
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I understand your concern. Breast cancer runs amok in my moms family so I was concerned about not having chemo when my MO said he didn’t think it would be necessary. Ihad the Mammoprint and came back low risk. The waiting for results was a hard time because I wanted answers and was ready to start treatment. I’m glad we waited. Mine came back low risk so we opted to go straight to Tamoxifen.
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TaRenee—Thank you for your response and for understanding that I had a reasonable concern. I wish we would have known about the MammaPrint and did that test first. It would have spared a lot of personal angst and avoided such strained discussion with the oncologist. I’ll be fine with the result either way
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Garifalia:
Similar situation here -- though mine came in at 14 (which I know is lower) but I wanted to be very sure with the NO chemo decision. My mom is a survivor and quite a bit of prostate cancer on maternal side of my family, which I've read may be related to ILC. (Which my mom and I both had, though all BRCA, etc., negative.)
Mamma came in low risk. I was happy in any case to have all the info I could. Why would we not want to know all we can???
Hope yours is low risk and you can rest easy with your decision. Good luck!
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Thank you EastcoastTS! I tested negative for BRCA mutations too, but I developed BC at the same age as my mom so I think there’s a genetic link somewhere. She was ER+PR+ HER2 neg too. I’ll post my result when it comes in
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My local Oncologist didn't want to,do a Mammaprint or Oncotype test saying that these tests should only be done if you don't want chemo. I went and had a 2nd opinion and she has ordered a Mammaprint and said if it came back as a Low risk, that I would not need to do chemo. I don't know how I feel about not doing chemo if the Mammaprint comes back low risk. Has anyone had their doubts about not doing chemo and has anyone had chemo with a Low risk result?
My Breast cancer is Invasive ductal Stage II Er+, Pr+, her2-. Grade 1, 1/5 sentinel nodes positive. Genetic testing was also negative
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what is a mammoprint
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it is a test done on the tumor to determine whether you are Low risk or High risk of your cancer returning. It also determines of you will need chemoor not.
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ahw, You might want to ask your first MO why they don't recommend chemo for you. I believe that the higher grade tumors respond better to chemo than the lower. I would be surprised if you were a high MP. Sometimes the risk of chemo out-weighs the benefit I was offered, but declined the MP test, after getting an intermediate onco-score. I think the MP is becoming more of a standard practice than it was when i was DX'd. Best wishes to you all!
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thanks! My local MO want to do Taxotere and Cytoxan and I think I would feel better with chemo even if MP is Low risk
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I think the grade of the tumor is a big factor with the onco and mamma print tests. I am Stage 1, no lymph node involvement and clear margins on a 1.8 cm tumor but my tumor grade was a "C" and the mamma print gave me a "high risk" score.
I think the Mammaprint is the latest generation of genetic testing but oncotype still seems to be more recognized.
Side by side, Mammaprint looks at 70 genes associated with recurrence when onco is less than 20. We requested the mamma print and it was about 2 weeks to hear back.
I have had one infusion of TC and my second infusion is next Wednesday. I'm glad we did Mamma because I did NOT want chemo and this was the deciding factor.
God bless you girls waiting on test scores. Once you get this last piece of the puzzle, you can move forward with a plan and that takes some anxiety away.
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lizabeth, you are so right about the anxiety diminishing as treatment is starting. I guess it makes us feel like we are fighting back and doing something positive. I hope you tolerate TC well. Drink plenty of water and stay as active as you can. The SE's are cumulative. ((HUGS)).
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Keep the Faith-thanks for the heads up, I was wondering how the SEs are with each subsequent treatment. Love your log in name-God is Who sustains me. :-)
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ahw1971 I was totally prepared for chemo. I think I actually wanted it because I just wanted to DO something. When my MO said no chemo I was rather taken aback. I asked questions, got more information, and finally just trusted the science and said okay. I’m thankful not to have to go through what so many others are with chemo, but sometimes I just hope I’m doing the right thing. I think I might mentally feel better with chemo but if it’s not going to be effective, why put myself through that
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TaRenee:
I'm right there with you. Same sentiment. Didn't do chemo and was glad -- but then fear: should I have done chemo? I trusted science (and doctors), too.
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To those of you who are uneasy with their decision not to do chemo based on Mammaprint result - keep in mind, that being Low Risk (Luminal A) doesn't just mean you DON'T NEED chemo, it also mean chemo may not be very effective for your cancer. So, while it may make you feel better mentally, it may be doing more damage to your body than helping you fight cancer. Simple cost-benefit analysis.
(take it from someone who is doing neoadjuvant chemo, and as part of the clinical trial I'm in my tissue was sent for MammaPrint - they don't need Luminal A in the study)
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TaRenee---I totally get what you said---I had those same thoughts. I actually found myself worrying about not getting chemo, and didn't understand why my MO's nurse was so happy for me to not get it. But yes, like FarAwayToo said, Mammaprint shows little benefit. And that's what my MO said...she said the risk of side effects outweighed the benefit for my luminal A cells.
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I'm in Europe where ideas are a bit different than in the US and when asking about Mammaprint or Oncotype was told that they aren't really guidelines but in any case it is the tumor markers which decide for chemo or not. With any lymph node involvement they state that chemo is a must to ensure that rogue cells aren't elsewhere.
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Amelia01---that's interesting that they aren't using the Mammaprint more in Europe. It was invented in Europe--Netherlands I believe. You'd think it would be popular.
Things are definitely so different. I think here in the US, tumor markers aren't often routinely done unless the cancer is advanced or they are monitoring metastatic disease.
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Amelia01:
I believe that your team was saying that in your specific situation, with 17/21 positive lymph nodes, the Oncotype and MammaPrint tests are not within your local guidelines. This would also be the case in the USA, Canada, and the UK, considering lymph node status alone. The various guidelines do not differ in that regard (with more than three positive lymph nodes).
gb2115:
Amelia received case-specific advice that she is not eligible for either the OncotypeDX ("21-gene") test or the MammaPrint ("70-gene") test. These tests would not be indicated for a person with 17 positive lymph nodes under applicable consensus guidelines in the US or under formal eligibility criteria from the test providers either.
Other patients in Europe with different pathologic features may indeed be eligible for and may receive the MammaPrint test under their local consensus guidelines. Patients should seek case-specific advice from their Medical Oncologist, any may be interested in consulting the current texts of their local guidelines for their information. Multiple guidelines may be in play, including regional European as well as national guidelines. The policies of health authority payors may be a separate question.
ESMO's guideline (European Society for Medical Oncology) for primary breast cancer in 2015 provided very generally:
"Gene expression profiles, such as MammaPrint (Agendia, Amsterdam, the Netherlands), Oncotype DX Recurrence Score (Genomic Health, Redwood City, CA), Prosigna (Nanostring technologies, Seattle, WA) and Endopredict (Myriad Genetics), may be used to gain additional prognostic and/or predictive information to complement pathology assessment and to predict the benefit of adjuvant chemotherapy. The three latter tests are designed for patients with ER-positive early breast cancer only. The clinical utility of Mammaprint and Oncotype DX is still being prospectively evaluated in large randomised clinical trials such as MINDACT for Mammaprint, WSG PLAN B trial, TAILORx and RxPONDER for Oncotype DX."
Since the, the primary results of MINDACT have been published and local guidelines may have changed. See for example, this press release from Agendia (the provider of the MammaPrint test).
More recently, the St. Gallen International panel noted in 2017:
"The Panel agreed that a number of gene expression signatures served as prognostic markers in the setting of adjuvant endocrine therapy in node-negative breast cancers, including the 21 gene [OncotypeDX] recurrence score, the 70 gene [MammaPrint] signature, the PAM50 ROR score, the EpClin score, and the Breast Cancer Index. The Panel endorsed all of these assays for guiding the decision on adjuvant chemotherapy in node-negative tumors as they all identify node-negative cases at low risk, with an excellent prognosis that would not warrant chemotherapy [23–27]. [NOTE: Our local ASCO guidelines are more nuanced than this, and do not broadly support the use of the MammaPrint test in all cases.]
Nodal status is a strong prognostic factor regardless of gene expression signature. The Panel agreed that gene expression signatures offered information that can refine the prognosis for node-positive breast cancers. However, the Panel did not uniformly endorse the use of gene expression signatures for making treatment decisions regarding adjuvant chemotherapy in node-positive cases. The 21-gene recurrence score and the 70-gene signature have now been evaluated in prospective studies including small numbers of node-positive cancers. In the prospective trial (MINDACT), only patients with node-negative, or one to three positive nodes were included. Patients with low-risk tumor scores and a limited degree of nodal involvement appear to have a good prognosis with or without chemotherapy [28, 29]."
In the US, the various guidelines from ASCO and NCCN also differ somewhat in what they provide regarding the use of these tests node-negative versus node-positive disease. Here as well, patients should seek current, case-specific expert professional advice from their Medical Oncologist.
BarredOwl
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