Low Oncotype Score = High Probaility of Surving Breast Cancer

A few weeks after my surgery, I received my personal Oncotype DX score. This score is from a test that was done on my tumor tissue. Here’s an explanation of the test that’s from BeWell.com. You can find the whole article at  http://bewell.com/ArticleDetail.aspx?id=2296&type=1:  

“The Oncotype DX test determines how 21 specific genes – 16 breast cancer related genes and 5 reference genes – are expressed (that is, their level of activity) within a tumor sample. The measurement of these genes is combined into an individualized result called a Recurrence Score®. The Recurrence Score is a number between 1 and 100 that correlates with the likelihood that your breast cancer will return (metastasize) and also indicates whether you are likely to benefit from chemotherapy.”   The test is not appropriate for everyone with breast cancer.  You can talk to your doctor about it for more information.

My score was 11.  The lower the score, the better your chances are that the cancer won’t recur within 10 years and the less likely you are to benefit from chemotherapy. My score meant that I had a 7% chance of recurrence.  I was thrilled to get this news, but it also made me feel guilty.  I know there are other women who weren’t so lucky; who are going through chemo and dealing with its side effects.

I also began to second-guess the treatment that was recommended.  My oncologist, Dr. Wang, was thrilled with my low score and called me right away to tell me that I would probably only need to take the oral anti-estrogen, tamoxifen, for 5 years. No chemotherapy. That was great. But even though I didn’t want chemo, I almost came to expect it. I was mentally prepared for it.  So when the results were tallied and my options were put before me, I began to question if taking tamoxifen alone would be the right thing.   I had done a lot of research on this topic, but I just couldn’t shake this uneasy feeling.  I looked back over all of my test results, including the pathology report, and did more research on the Internet.  I felt more reassured, but I did find one thing in my pathology report that troubled me.  Apparently 10% of my 2 centimeter tumor was a more aggressive type of cancer, called micropapillary carcinoma.  I know that’s not much, but I wondered what that meant in terms of my Oncotype score.  I asked my breast surgeon, Dr. Derhagopian, if the micropapillary component of my tumor would in any way change the result of the Oncotype DX score, and his answer was “No”.  He agreed with Dr. Wang and said that he was very confident that tamoxifen would be the right treatment for me.  He said that he had been quite certain that I would get a low Oncotype score because all of my lymph nodes were negative.  I had two of the best breast cancer doctors in South Florida reassuring me that hormonal treatment would be the way to go. So off to the pharmacy I went.  I’ll write more about my experiences with tamoxifen at a later date.

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