Surgery on 12/5 and still waiting for Oncotype DX results
I'm mainly writing to vent, but if anyone can explain why chemo (if needed), is supposed to precede radiation, I would be interested to know.
I had a lumpectomy and sentinal node removal on 12/5. Fortunately clean margins and no lymph node involvement. Two tumors side by side, the larger is 1.3 cm. Nottingham Grade 3. ER/PR positive, HER2 negative, Ki-67 unfortunately high 30-40%.
I met the medical oncologist on 12/15 and she ordered oncotype dx testing to help determine whether chemo would be. beneficial, or whether to move straight to radiation. I was told there might be a wait because of the holidays, and not to expect the results until the week of 1/3. I have called and left messages to confirm that all was on track and if there is an updated estimate, and still not heard back. My radiation simulation is scheduled for this Friday 1/13, assuming chemo is not needed first.
I just called the exact science/precision testing lab, and they say that although they received the order from the doctor on 12/16, they didn't receive the sample until January 4. Their estimated completion date is not until 1/18 - slightly more than 6 weeks post surgery.
My question is why is it recommended that chemo precede radiation, and does it ever make sense to reverse the order if the oncotpye dx results are delayed? I got the impression that radiation (not the simulation, but the actual start of treatments) was to begin around week 6 post surgery, and on this schedule, if chemo isn't indicated, I'm picturing it would be more than 8-9 weeks for me. Any information would be appreciated!
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Chemo, if needed, is done before radiation because there is a better disease free and metastasis free survival rate. Also, insurance won't pay for your Oncotype dx (close to $5,000) if you have radiation before post-surgery chemo.
Like you, my sample was delayed. I went to my simulation appointment before I got my results. They did schedule future radiation treatments and said they would be cancelled and rescheduled if I needed chemo. Thankfully my score of 24 meant that there was no benefit of chemo (by one point) so I went with the plan. My first actual treatment took place 8 weeks post surgery. There are a variety of studies of the surgery-radiation time interval suggesting 6,8,12,16 and 20 weeks. A study which compared these different recommendations said that the time interval was not statistically significant until it was greater than 20 weeks.
If you have a radiation oncologist it might be worthwhile contacting them to make sure the timing works out. Having been in the same situation I understand how stressful this is. I hope it all goes well.
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Thank you, your response is very helpful
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