Mammaprint and Oncotype Dx

FDM, I can't answer your question, but I think the onco was designed for early stage, hormone receptor pos, node neg and the menopause stage may be a factor also. I think I read somewhere that it is most useful for post-menopausal, but not positive. I am hormone receptor pos, node neg and post-menopausal. Family history also, but BRAC-. There was a link in the forum somewhere for the oncotest website-it was informative. Maybe you can find it. My MO has ordered the onco test. I was supposed to have an appt today, but results are not in yet...have to wait til Tuesday.

My MO did mention that if the onco results were in the gray area, she may order the mammaprint. It tests more genes than the onco, but I am not sure which is most useful in your situation. I hope that helps! Making these decisions is hard for sure. Good luck!

Hi Everyone

I posted on another message and thought to try this thread too.

I was diagnosed 8 Nov (IDC grade 2 , ER/PR +, CerbB2 -) and had my double mastectomy on the 14th. I went in to the operation with the hope that my nodes would be clear and that I would be able to preserve my nipple in my left breast which had the malignant tumor (1.7cm)

Unfortunately, at least one node was affected (my doc thinks that it is only one node due to preliminary testing during the surgery.) The full report comes out next week.

My surgeon says that because 1 node was affected, the oncotype dx test is ruled out (I'm 37). Another disappointment. I'm concerned/dreading chemo and am even considering not undergoing it. Am I completely ruled out for the oncotype dx test? How about mammaprint?

Any help would be great.

compass - some oncologists are now ordering the Oncotype Dx test with 1-3 positive nodes. Here is a study link, and another thread on BCO with this same question which may have some useful info:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145540/#ref-2752647992

http://community.breastcancer.org/forum/108/topic/786838?page=2#idx_31

My score was 11 - my age much older than you at 63 - 2.0 cm tumor and no node involvement.  ER/PR positive and HER2 negative.  My tumor staged at 1C and the grade of my tumor was midrange.  My understanding from my oncologist is that the Oncotype testing gives more details on the risk of metastasis.  Isn't the decision ultimately up to the individual to do chemo or not?  Based on my score I didn't chose chemo.  I would have made the same decision if my score had come back anywhere up to 18.  Otherwise, why do the testing if I had decided I wanted chemo no matter what?  The oncologist questioned me before the test about whether I would have chemo if the score reflected it - or if I would opt out no matter what.  I agreed that I would do chemo if the risk was in the high range, and we would discuss it further if it were in the midrange.

RainDew - Everything about it is an unknown.  After the MX, clear margins and the finding of no cancer in the 3 nodes, I was expecting only to take a pill for five years.  My surgeon told me I was "cured".  The next appointment with the Oncologist was a shock.  You mean I can still have cancer cells in my blood stream and lymph nodes even if they weren't in the sentinel node?  Yikes!  So when the Oncotype DX test was explained, I felt some sense of relief because I looked at it as an objective view.  I have come to the conclusion that I will never feel "cancer free" again.  I am working on changing my outlook and focusing on the things that are important to me.  I'm not sure I will ever return to the "ignorance is bliss" stage I was at when the mammogram detected the lump.  I felt great before that diagnosis and to be honest, I still feel the same, healthwise.  I have reduced my risk by having both breasts removed and am taking arimidex for 5 years.  That is all I can do so I am trying to move on.  I hope you can find some sense of peace with whatever decision you make.

I ended up with an onco score of 21. Intermediate. Opted for chemo. I never did the mammaprint test; I didn't want to wait any longer and felt it may muddy my decision more. Had 4 tx's of TC. Was manageable and not that hard for me. I know we are all different. I finished my rads last month and feel as though I am back to how I felt before my DX, with the exception of needing more rest than before. I will be curious to see the trial results of the intermediate scores when they come out next yr. 

Good luck with your decision(s) and treatments!

raindew...annicemd started a thread Stage 1 Grade 1 Premenopausal.....you should read it.  Of particular note, when Annice started the thread, we hadn't info regarding the SOFT and TEXT trials. At the most recent ASCO meeting, some important preliminary info came out of the meeting.  Likewise, last year some important info was released regarding the ATLAS and atTom studies.

I strongly recommend that you familiarize yourself with those studies and speak to your physician about them.  Also check out the NCCN'S website and read the professional version of the breast cancer treatment guidelines.  

No single test is perfect 100% in its prediction or certainty. Every decision and factor is an odds game. All you can do is weigh them in your case - get a lot of info as you and MO are, and mak a most informed decision.  It's hard.  

yep! Voracious you have me right (dec for SOFT, maybe 2015 if lucky for TAILORx as I understand it).

And for the excellent prognostics, I am grateful every day. Every day. So I am very aware that it might seem whiny to complain about waiting or the difficulty I am having making tx decisions - god knows, I am lucky to have decisions to make.

Thanks again - nice to hear from kindred souls.

Just got my Onco back today with a score of 14. I am NOT doing chemo. I am diabetic and 60 years old. I am going for Rad set up first of July and then forward with Hormone treatment. it is your decision but 14 is in the low range and it's risky for me personally.

Ask that your case be immediately presented to a tumor board for review.  Good luck!

Geezzz...now that I read these posts I wish I had insisted on a Mammoprint.  When I read about it and mentioned it to my oncologist's PA (who didn't seem that well versed) she said that they don't do that since it isn't empirical enough (huh?) and that at a oncatype score of 21 - that they don't recommend chemo.  At least if Mammaprint had given me a high risk I would be feeling better today after an extreme day of body aches.  Just goes to show that we have to be our own advocate.  I moved from CA to SC - what did I expect?  This isn't a medical mecca.  I thought that my oncologist was decent here (was at MD Anderson) but she's young - and although she didn't necessarily agree with the PA's opinion (PA was covering for her when she was on vacation) she just kept on saying "it's up to you". (from biopsy to surgery, path went from .5 centimeters to 1.9 centimeters and from Grade 2 to Grade 3)  So - she was no big help.  So I called my former oncologist in CA and he said - definitely do the chemo since 1)  you don't know if you'll be able to tolerate hormone pills for 10 years and 2)  this is your second time around (Stage 0 three years ago).  Thank god he had an opinion!  So, here I am feeling like a truck hit me.... but at least someone had an opinion.  I agree with Rain - this stuff can make your head spin.

Rain - as you know, l made a decision to drop out of chemo, and now I'm second guessing myself.  If the chemo wasn't that darned hard and the TailorX study for us middle range oncatype was in, and I wasn't Grade 3 then it would be MUCH easier.

I'm thinking about getting the Mammaprint test done.  Did it help you with your decision?

I've read on the Johns Hopkins website that chemo isn't as effective with your Grade 1 - did your MO talk about that?

I thought that I was over the chemo hump but gastro stuff reared it's ugly head again.  Not sure that I can go back for more poison next week.....

MomtoIrishQ

Glad to read this discussion since I have an oncotype score of 21 and Mammaprint was suggested.  Took a few days to make sure they had enough tissue sample and clear it with my insurance, but now i'm waiting for the Mammaprint test results.  I kept thinking that I probably wouldn't need chemo, but now reading others stories there is no way to know for sure.  I'm grateful to have more info from this test - even if it isn't everything. I'm also participating in a study at my cancer center with these results, so hopefully over time more people will have it and they'll have more science on this.  I think I will get test results next week...

Aloha Girls, hope this thread is still going. I had an oncotype dx score of 0. Three Mo's said they never saw a score or 0.At first I was quite thrilled. But you know how it goes ....you get thinking about the worse. Now I am wondering if the lab sent the unaffected breast tissue to Oncotype instead of the breast tissue with the cancer in it.  Has anyone ever heard on a score of 0?