Hello everyone
Has anyone had the Oncotype DX test? I had one following a lumpectomy in March the results of which led to a mastectomy and axilla node dissection in June. My Oncotype score was 21 and I decided not to have chemo but proceed with hormone therapy (zoladex injections and anastrazole) and adjuvant radiotherapy (currently session 8 of 15). I am ER positive, HER2 negative, Grade II, stage 3 and my tumour was 61mm with multicentric lesions. I’m now worried I should have bitten the bullet and had the chemo…
My NPI is 6.22 and without the Onctoype I would have had chemo for definite and whilst I know that the latter trumps any other prognostic test I still can’t help but worry.
Hi pinkpony
This is always a difficult one as each tumour is different, my NPI was 4.2 which put me in the moderate group but my oncotype dx score came back as 40. Like you I’m ER+, HER2-, but grade 3, with a 9mm tumour, node negative, I don’t know the stage as my hospital for some reason don’t do stages (goodness knows why). I have just finished chemo and am waiting to start radiotherapy. I have just started Letrozole and oral bisphosphonates (was on the infusion during chemo).
Although my tumour was tiny compared to yours, it was more aggressive hence the high dx score.
I’m guessing if you are taking Anastrozole your postmenopausal so over 50??? (I hope I’m not offending here), recent studies suggest that a score of 0-25 over age of 50 won’t get any benefit from having chemo in addition to hormone therapy scores of 26 and above would benefit from chemo (source breastcancer.org.uk). My oncologist did say that I would only be offered chemo if my score was 26 or above and I’m 53.
The onco test helps decide whether chemo would benefit whereas the NPI doesn’t.
It’s natural to worry, it’s really hard making decisions regarding something we know very little about, it would be great to have a magic wand but unfortunately we haven’t. If your worries continue, might it be a good idea to discuss your concerns with your BC nurse or better still your oncologist as they had the results of your test so should be able to discuss it further with you. Maybe you could try and link up with ‘some one like me’ on this website, they would understand your worries and could talk them through with you.
Take care
Joemic x
I hope this helps - I was told by my consultant that the NPI score is quite old fashioned and that what is needed is a way of combining the NPI and oncotype but they haven’t got a method of doing that yet. I was really worried by my NPI and confused about chemo. NPI implied do chemo, oncotype to not do it. So I didn’t do chemo and felt v relieved to escape. Then I got really panicky that maybe I should have done it because it was large, multifocal, positive node, grade 2. I shared these fears with my bc nurse and she talked me through all the logic again, saying it’s a lot to take in at once, and reassured me again. She explained the risk/benefits of chemo again and what the oncotype tests for . Maybe you could ring your nurse too? She said she thinks it’s all part of the psychological process - it’s all such a shock your mind revisits decisions and questions them all over again. She also recommended a Dr referral to the gym - I’d never been to one ever before and I felt so tired - but actually it’s helping me feel I can do something positive. I really wish you well. Do chat to this places phoneline too, they’re really good, and Macmillan, they really listen and are so helpful and up to date whereas some news articles don’t really understand the science etc or that every person’s case is individual