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Topic: Biopsy vs. Oncotype DX - deferent diagnoses.

Forum: Mixed Type Breast Cancer — Meet others who have mixed type breast cancer.

Posted on: Jan 18, 2019 07:07PM - edited Jan 18, 2019 07:08PM by Julia46uk

Julia46uk wrote:

hello,

I am new here, have been reading bords since my diagnosis in November 2018 and finely decto join. I was first diagnosed with DCIS by biopsy and decided to do Lypectomy. After my surgery in December pathology should that I also have a 3mm IDC and I am triple positive. Now I just got my Oncotype results back and it reported that I am er-,pr - and her2+. Is it even possible? I am waiting on call back from the oncologist but ...what is more accurate with er/Pr diagnosis and how they could be so different in so small tumor?

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Jan 18, 2019 07:50PM LoriCA wrote:

I have had multiple biopsies done since my dx and the pathology has always been ER+ PR- HER2+. Somehow somebody messed up and ordered an Oncotype DX on my last biopsy (I was Stage IV de novo so a recurrence score is pointless) and the Oncotype DX said ER-. Sounds like both of us have pathology reports saying ER+ (in my case multiple times) yet Oncotype DX says ER-. I'm interested to hear what others have to say about their experience because these things make a huge difference in treatments.

IBC Stage IV de novo - presented in right breast, within days spread into left breast, skin, chest wall, metastasized into brachial plexus (lost complete use of right arm for several months), liver and throughout skeleton. Dx 9/8/2017, IBC, Both breasts, Stage IV, metastasized to bone/liver/other, Grade 3, ER+/PR-, HER2+ (IHC) Chemotherapy 9/25/2017 Taxol (paclitaxel) Targeted Therapy 2/5/2018 Perjeta (pertuzumab) Targeted Therapy 2/5/2018 Herceptin (trastuzumab) Chemotherapy 11/25/2018 Taxol (paclitaxel) Radiation Therapy 1/29/2019 Whole-breast: Breast, Lymph nodes, Chest wall
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Jan 18, 2019 10:07PM Moderators wrote:

Dear Julia46uk,

Welcome to the BCO community. We are sorry about your diagnosis but so glad that you reached out to our members for support and information. We hope that you will make good use of the experiences shared here and stay active. Let us know if you need any help learning how to navigate your way around the boards.

The Mods

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Jan 19, 2019 08:33AM - edited Jan 19, 2019 08:34AM by Meow13

I thought tumors had to be atleast 5mm to send to oncodx. Maybe they sent the DCIS portion.

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Jan 19, 2019 12:53PM - edited Jan 19, 2019 12:54PM by windingshores

It's possible that the biopsy had more of either DCIS or IDC, and the Oncotype more of the other one.  Also the Oncotype is done with a slurry, not specific discrete pieces of a sample. You can call Genomic Health, the Oncotype company, to discuss. They are pretty informative on the phone.

Dx 2/2015, DCIS/ILC/IDC, Right, 1cm, Stage IA, Grade 3, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery Lymph node removal; Mastectomy: Right Surgery Mastectomy: Left; Prophylactic mastectomy: Left Hormonal Therapy
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Jan 27, 2019 10:48PM Julia46uk wrote:

So I have somewhat update. My original MO who requested the Oncotype just told me to egnore the ER/PR - as biopsy is always more accurate. I can just ignore things without a good explanation, so I reached out to my second opinion MO and he said that after board meeting with 3 others MO he wants me to get another second opinion with professor at John Hopkins. I am waiting for call back from Hopkins coordinator to get my appointment. If anyone was in the simulator situation and willing to share I would appreciate information. Also the second opinion MO said that he would not send me for Oncotype to begin with as my tumor is only 3 mm and her2 positive, but because we do have Oncotype we can't just ignore it

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Feb 7, 2019 07:59PM windingshores wrote:

My biopsy results were wrong in terms of HER2. If I had gone by the biopsy results I would have had chemo and Herceptin. Luckily I had neither.

Dx 2/2015, DCIS/ILC/IDC, Right, 1cm, Stage IA, Grade 3, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery Lymph node removal; Mastectomy: Right Surgery Mastectomy: Left; Prophylactic mastectomy: Left Hormonal Therapy
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Feb 7, 2019 08:02PM - edited Feb 13, 2019 04:24PM by Moderators

Chiming in to post this in case anyone would be interested:

$25 for participation: Genomic Health is looking for people (Age 70+) who have used the Oncotype DX test for invasive breast cancer to share their story in a 30 minute phone interview. The project is called NoMatterMyAge. Email BWang@genomichealth.com if you are interested and let her know a bit about you (where you are located, your age, phone number). Thank you!


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