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Aug 9, 2021 10:01AM
If you are node negative, the Oncotype results are based on the TAILORx study. Here is the tumor criteria for participation in the study:
"tumor size 1.1–5.0cm (or 5 mm-1.0 cm plus unfavorable histological features, defined as an intermediate or poor nuclear and/or histologic grade, or lymphovascular invasion)"
This means that Oncotype results are not very representative for those of us who have a smaller tumor. Your 6mm tumor fits into the criteria, but there likely were very few patients in the study with tumors this small. The average tumor size in the TAILORx study was 1.75cm.
Tumor size is one issue with the Oncotype score. Age and grade are other issues. All 3 of these factors have all been shown to affect recurrence risk. Genomic Health (the Oncotype company) don't publicly acknowledge this, but they do unofficially recognize this by making available to Medical Oncologists a computer model (RSClin, which replaced the earlier RSPC Model) that takes 4 inputs - the Oncotype score, the patient's age, the tumor size, and the tumor grade - and recalculates a new 9 year recurrence risk. My MO also refused to run an Oncotype test for me, but he did show me how this model would adjust my recurrence risk at various scores. Even with a 40 score, which falls well into the "you would benefit from chemo" category, once my age (older than average), tumor size (smaller than average) and grade (a 2, which is average for TAILORx) were factored in, my recurrence risk would drop down into the "no significant benefit from chemo" range. My MO's decision was based on his position that no matter what the Oncotype score was, he would not recommend chemo because Genomic Health's own computer model would readjust my risk into the "no benefit from chemo" range.
How old are you and what is the grade of your cancer?
Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole