Oncotype DX age difference for medium risk


I was just wondering why for an oncotype score between 15 and 20 they say no benefit if over 50, but should discuss if under 50.
I am 51 but in that score region for both rumours (multifocal ) and told no benefit from having chemo. However, looking at the literature, if I was 50, there might be. Don’t get me wrong, delighted to not need chemo but just concerned as so close to age cutoff.
Is it because chemo can effectively make you menopausal so if under 50 would reduce estrogen levels? I have been on Exemestane and Zoladex since July, so thinking that ‘protects’ me as I will be chemically menopausal.

Just curious (and a little bit paranoid!).


Hi bordercat,

Thanks for posting.

The Oncotype DX test is used in situation like yours when the benefit of chemotherapy is unclear. The results predict the risk of the breast cancer returning (recurrence score), the risk of distant recurrence and the benefit from adding chemotherapy to hormone therapy to reduce the risk of the cancer coming back.

A recurrence score of 15-20 in women like you who are over 50 years predicts a 1% benefit of chemotherapy. For women under the age of 50 years with the same recurrence score, the benefit of chemotherapy is predicted as 1.6%. We would always suggest you discuss your recurrence score with your treatment team if you have any questions about the benefit of chemotherapy in your situation. More information can also be found on the Oncotype DX website.

Exemestane (an aromatase inhibitor) is not used on its own as a hormone therapy in premenopausal women as it’s not effective while the ovaries are making oestrogen. Zoladex (goserelin) is therefore given alongside it to switch off the production of oestrogen. This is known as ovarian suppression. We know that women aged around 40 and above are less likely to have their periods return after completing chemotherapy and this may bring on the menopause.

Talking to someone who has had a similar experience to you can often be helpful. Our Someone Like Me service can match you with a trained volunteer who’s had a similar experience to you. You can be in touch with your volunteer by phone or email and they can share their personal experiences to answer your questions, offer support or simply listen to how you are feeling.

We also offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in. They include face to face and online courses and events.

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Best wishes


Breast Care Nurse

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