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Topic: oncotype and BRCA

Forum: BRCA1 or BRCA2 Positive — Connect with others who have either a BRAC1 or BRAC2 breast cancer gene abnormality

Posted on: Jan 27, 2013 01:04PM

heybella wrote:

I am anxiously awaiting the results of an oncotype test. I'm BRCA1 and  had a mastectomy three months ago after DCIS was found. Pathology revealed a 1.5 cm  tumour there too- no nodes involved and HER -ve.; ER/PR +.

  I'm wondering if anyone had a tumour that looked like it would end up with a low oncotype score but ended up higher because they were BRCA.

 Thanks!

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Posts 1 - 12 (12 total)

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Jan 27, 2013 01:16PM ballet12 wrote:

I'm not BRCA positive, but how would you know that the oncotype score was higher because of BRCA?  Is BRCA added into the oncotype equation in some way, or is oncotype just based on the pathological characteristics of the tumor?  There are some types of tumors that are more common in BRCA positive women (triple negative), and that would make the recurrence risk potentially higher, but because the tumor is triple negative.

Dx 8/2012, DCIS, Right, 5cm, Stage 0, Grade 3, ER+/PR- Surgery 10/05/2012 Lumpectomy in one or both breasts: Lumpectomy in my right breast Surgery 07/27/2012 Lumpectomy in one or both breasts: Lumpectomy in my right breast Surgery 10/25/2012 Lumpectomy in one or both breasts: Lumpectomy in my right breast Radiation Therapy 01/11/2013
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Jan 27, 2013 04:29PM Miller1353 wrote:

My onco would not even try the OncoType score. Granted, my estrogen marker was a measly 1%, so I may not have received a score anyway. She said the BRCA+ test was what she determined my treatment on, along with tumor size, nodes, etc. She said my OncoType score "would be sky high". I really did not question her. I knew I was headed for chemo, BMX and hystectomy. My ki-67 was 76%. along with the grade 3, my tumor was aggressive.

I believe, in general, that most BRCA+ women have earlier onset and more aggressive tumors. I chose the most aggressive treatment options..she said I would be a fool not to do so.

Dx 10/23/2009, IDC, 1cm, Stage I, Grade 3, 0/5 nodes, ER-/PR+, HER2-
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Feb 5, 2013 07:22AM IllinoisNative wrote:

I'm BRCA 2 positive and my onco score was 70...I don't know too many people who have score that high.  But I'm practically triple negative (weak ER and PR positive) and I'm told that a higher onco is normal in that case, I think.  However, my doctor told me that chemo brought my onco score down to the 20's so I'm at the same risk as most breast cancer patients now.

BRCA 2 Positive Dx 11/27/2010, IDC, 4cm, Stage IIa, Grade 3, 0/4 nodes, ER+/PR+, HER2-
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Feb 5, 2013 07:36PM heybella wrote:

My oncotype came back at 15 and confirmed that the tumour was strongly ER and PR positive. So it's tamoxifen for me- 

 Becuase BRCA women tend to get triple negative tumours I asked my onco. if mine was not because of the gene - but just a random occurrence. However, everyone has said because of my young age (I was 51 at diagnosis!) it was probably the gene - BRCA1 .

 Best of luck to all of you!!

Dx 9/2012, IDC, 1cm, Grade 2, 0/3 nodes, ER+/PR+, HER2- Hormonal Therapy 02/05/2013 Surgery 10/31/2012 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast
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Mar 21, 2013 11:08AM jsrose14 wrote:

hello,
i just recently had a bmx with TEs on march 6th. i had my first MO appointment yesterday and although my oncotype score was a 16 (in the low range) my tumor was consider a grade 3 but stage 1 with no node involvement and er/pr+ her2-. She seems to think that the benefits of chemo will not outweigh the risks and bascially only change my rate of recurrence by less than 2% which after hrt is 6%. I am wondering if anyone else with low oncotype scores but higher grade tumor chose or didn't chose chemo and why. my MO also explained that the onctotype pretty much trumps all of the other pathology. i am braca2 and had a hi KI67 score with poorly differentiated cells but that because my score was in the low range and there were no nodes and it is hormone receptive that chemo would not be recommended. that being said she definitely said there are women who still chose it--not exactly sure what i am feeling right now but would love to hear more from others with similar situations. i am also surprised because all of the original pathology indicated more aggression but as i mentioned she seems to feel that the oncotype trumps all. anyone else have a similar situation? I will definitely be seeking a second opinion mostly to hear the same thing and put my mind at ease to help make the decisions. i live in the philly area and would love any recommendations for MOs

thanks,
jsrose

BRCA2+, Oncotype score 16, LVI found in pathology Dx 1/25/2013, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2- Hormonal Therapy 09/06/2013 Arimidex (chemical name: anastrozole, class: aromatase inhibitor) Surgery 03/05/2013 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast; Lymph node removal (also called dissection): Lymph node removal (also called dissection) on my left side ; Prophylactic (also called preventive) mastectomy of one or both breasts : Prophylactic (also called preventive) mastectomy of my right breast ; Prophylactic (also called preventive) removal of the ovaries ; Reconstruction of my left breast: Tissue expander placement; Reconstruction of my right breast: Tissue expander placement Chemotherapy 04/30/2013 CMF: Cytoxan, methotrexate, and fluorouracil
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Apr 13, 2013 08:27PM Rebex wrote:

Hi jsrose14,
My diagnosis seems to be pretty close to yours and I am also BRCA 2 positive. I am still waiting for my Oncotype result which is driving me insane! I was just wondering if you've had a second opinion yet? What was the outcome?

Dx 2/28/2013, IDC, 1cm, Stage I, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 03/06/2013 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast; Lymph node removal (also called dissection): Sentinel lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my left side
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Apr 13, 2013 08:38PM jsrose14 wrote:

Hi rebex,

Thanks for your note. I am actually going next week for a second opinion. I went last week to another mo in the Philly area and really didn't like the appt too much but she basically said the same thing. I am hoping the woman I see next week is a bit more authoritative in terms of her opinion. I am getting more comfortable with the idea of not doing chemo but still pretty scared either way.

When did they do your test? I noticed we had surgery a day a part. I got my results back pretty quickly. Maybe a week or so. Good luck. Hoping for a low score. Please let me know the outcome.

Jsrose

BRCA2+, Oncotype score 16, LVI found in pathology Dx 1/25/2013, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2- Hormonal Therapy 09/06/2013 Arimidex (chemical name: anastrozole, class: aromatase inhibitor) Surgery 03/05/2013 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast; Lymph node removal (also called dissection): Lymph node removal (also called dissection) on my left side ; Prophylactic (also called preventive) mastectomy of one or both breasts : Prophylactic (also called preventive) mastectomy of my right breast ; Prophylactic (also called preventive) removal of the ovaries ; Reconstruction of my left breast: Tissue expander placement; Reconstruction of my right breast: Tissue expander placement Chemotherapy 04/30/2013 CMF: Cytoxan, methotrexate, and fluorouracil
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Apr 13, 2013 08:50PM Rebex wrote:

Jsrose,
They didn't send the Oncotype test out until last Monday. So I am told 10-14 days until we get a result. Gives us time to hurry and freeze embryos while waiting as once the result is in I've been told they want to act fast.

I just have this strong strong gut feeling that no matter what the results come back I want to do chemo to make sure we get it all. I don't know if I can manage through all the daily what if's.

I have an appointment next friday with a high risk breast oncologist for a second opinion. I will let u know what she says and you keep posted as well please :-)

Dx 2/28/2013, IDC, 1cm, Stage I, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 03/06/2013 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast; Lymph node removal (also called dissection): Sentinel lymph node removal (also called dissection) , Lymph node removal (also called dissection) on my left side
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Jun 11, 2013 07:36PM bernadf wrote:

Hi, ki situation is very similar . My RS is 16, stage 1,grade 3, ki 67 37%, 1.5 cm, N0, M0. ER and PR positive, her2negative. I have seen several physician and I dont find two with the same treatment. What happened with you? Yes or no chemo?I am afraid to do a wrong decision. It is driving me insane.
Thank you very much
I am 45 years old
I wish the best for you

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Jun 11, 2013 08:11PM jsrose14 wrote:

bernadf-
not sure if you were writing to me but I did decide to do chemo. it was the hardest decision i had to make in the whole process and tomorrow is my 4th treatment out of 8. chemo is not fun but i am hoping to just get thru it and move on. it's such a personal decision but i knew that when i thought about not doing it, there was too much worry for me to live with so i opted for it and my onc was fine with it. she said it was definitely reasonable.

good luck with your decision. i would go with the opinion that sits best with you. i also did not have agreement but ultimately went with my gut.

best,
jsrose

BRCA2+, Oncotype score 16, LVI found in pathology Dx 1/25/2013, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2- Hormonal Therapy 09/06/2013 Arimidex (chemical name: anastrozole, class: aromatase inhibitor) Surgery 03/05/2013 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast; Lymph node removal (also called dissection): Lymph node removal (also called dissection) on my left side ; Prophylactic (also called preventive) mastectomy of one or both breasts : Prophylactic (also called preventive) mastectomy of my right breast ; Prophylactic (also called preventive) removal of the ovaries ; Reconstruction of my left breast: Tissue expander placement; Reconstruction of my right breast: Tissue expander placement Chemotherapy 04/30/2013 CMF: Cytoxan, methotrexate, and fluorouracil
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Jun 12, 2013 07:35AM bernadf wrote:

jsrose

I greatly appreciate your answer. Probably it is not what I wanted to hear, because I am not sure to want chemo, but I have much fear about my final decision. Probably, for me  it is the most dificult decision in the process .

Just one more thing, what treatment you are using?

Thank you very very very much

The best for you

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Jun 12, 2013 09:13AM jsrose14 wrote:

Bernadf-
I am doing a regimen of chemo called cmf. I cannot see your statistics but did you have positive nodes?
Sorry you are having such a hard time deciding. I did as well but once you make a decision it gets easier.

Good luck
Jsrose

BRCA2+, Oncotype score 16, LVI found in pathology Dx 1/25/2013, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2- Hormonal Therapy 09/06/2013 Arimidex (chemical name: anastrozole, class: aromatase inhibitor) Surgery 03/05/2013 Mastectomy of one or both breasts: Mastectomy of my left breast, Mastectomy of my right breast; Lymph node removal (also called dissection): Lymph node removal (also called dissection) on my left side ; Prophylactic (also called preventive) mastectomy of one or both breasts : Prophylactic (also called preventive) mastectomy of my right breast ; Prophylactic (also called preventive) removal of the ovaries ; Reconstruction of my left breast: Tissue expander placement; Reconstruction of my right breast: Tissue expander placement Chemotherapy 04/30/2013 CMF: Cytoxan, methotrexate, and fluorouracil