Why Oncotype testing
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Topic: Why Oncotype testing
Posted By: singingknowles
Subject: Why Oncotype testing
Date Posted: Feb 24 2009 at 3:24pm
I am new to this site.
When my HER-2 came back neg yesterday, I was officially diagnosed with tnbc. Already had a lumpectomy Feb. 9. Stage 1, grade 2, .9cm., node neg. Can anyone tell me why did my doc. now order an oncotype DX test? Everything I find about the test is that it is ordered for horomone positive cancers. Nothing about tnbc's. 
Every time I get an answer to a test, I find out I have to have another before I can find out what my treatment is going to be. How long does it take for the oncotype test to come back? 
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Replies:
Posted By: Nancy
Date Posted: Feb 24 2009 at 3:31pm
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Hi there singingknowles,
Welcome , and I do know that there is another test now for TN similar to the oncotype for BC+. I just pm'd you, and poof...you posted. 
Just be glad that they are doing tests.  I will get back to you with a link for that test. If you sign off, I will send you a private message. Stick around..read the many posts, and let the gals welcome you also. 
Hugs,
Nancy
------------- Nancy
DD Lori dx TNBC June 13,2007
Lumpectomy due to incorrect dx of a cyst
mastectomy July 6 2007
chemo ACT all 3 every 3 weeks 6 tx Aug-Nov
28 rads ended Jan 2008
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Posted By: Nancy
Date Posted: Feb 24 2009 at 3:35pm
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Siningknowles,
Found it!!
Nancy
http://hormonenegative.blogspot.com/2009/02/new-test-helps-predict-outcomes-for.html - http://hormonenegative.blogspot.com/2009/02/new-test-helps-predict-outcomes-for.html
------------- Nancy
DD Lori dx TNBC June 13,2007
Lumpectomy due to incorrect dx of a cyst
mastectomy July 6 2007
chemo ACT all 3 every 3 weeks 6 tx Aug-Nov
28 rads ended Jan 2008
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Posted By: krisa
Date Posted: Feb 24 2009 at 3:47pm
singing, my onc sent my tumor to oncotype to really get a second opinion-and it was rejected and sent back. this confirmed that the first path report was indeed correct-tnbc.
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Posted By: singingknowles
Date Posted: Feb 24 2009 at 4:21pm
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Nancy,
Great article. I printed it and am going to fax it to my doc.
Thank you very much - you are awesome!!!
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Posted By: kirby
Date Posted: Feb 24 2009 at 4:54pm
Nancy, thanks for posting that article for all. I was unaware that they now had oncotype testing for us. Do you know who [lab]or where this is being done?
------------- kirby
dx Feb. 2001. Age 44 Lumpectomy
2cm. no nodes stage 1 grade 3
4 rnds AC, 35 rads
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Posted By: Nancy
Date Posted: Feb 24 2009 at 5:04pm
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Kirby,
I was just re-reading that article and I will do some searching, as it says this was in the Journal of Clinical Oncology, and Netterz send me articles to post from Oncostat, so maybe in there some where also?
I wish they would write where these tests are done instead of someone with cancer having to do a world wide search. Don't they know who is looking for these things? GRRRRR!!
Hugs,
Nancy
------------- Nancy
DD Lori dx TNBC June 13,2007
Lumpectomy due to incorrect dx of a cyst
mastectomy July 6 2007
chemo ACT all 3 every 3 weeks 6 tx Aug-Nov
28 rads ended Jan 2008
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Posted By: Nancy
Date Posted: Feb 24 2009 at 5:12pm
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Kirby,
I just emailed the woman whose blog this came from. If you look at the side of the article you will see a picture of her. I had emailed her several times a few weeks ago. I will let you know if I hear from her, and I will still search.
Nancy
ps...I had posted this on our news forum.
------------- Nancy
DD Lori dx TNBC June 13,2007
Lumpectomy due to incorrect dx of a cyst
mastectomy July 6 2007
chemo ACT all 3 every 3 weeks 6 tx Aug-Nov
28 rads ended Jan 2008
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Posted By: Nancy
Date Posted: Feb 24 2009 at 5:41pm
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Kirby,
I just emailed the Washington University of Medicine as to this test, and gave them the link to this woman's blog and the article. It mentioned the Siteman Cancer Center. If I hear anything I will post it.
Time for a glass of wine ladies!! 
Hugs,
Nancy
------------- Nancy
DD Lori dx TNBC June 13,2007
Lumpectomy due to incorrect dx of a cyst
mastectomy July 6 2007
chemo ACT all 3 every 3 weeks 6 tx Aug-Nov
28 rads ended Jan 2008
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Posted By: Nancy
Date Posted: Feb 24 2009 at 8:08pm
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Kirby,
I just received an email from the woman Pat. She said:
Nancy: I remember hearing from you. The test I wrote about is still experimental and so it will, unfortunately, have to work its way through the process and into the market. I expect it will be at least a year or two before we can get it. Hope all is well with you. Pat
I will see if I get a response from the cancer center which I also emailed.
Nancy
------------- Nancy
DD Lori dx TNBC June 13,2007
Lumpectomy due to incorrect dx of a cyst
mastectomy July 6 2007
chemo ACT all 3 every 3 weeks 6 tx Aug-Nov
28 rads ended Jan 2008
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Posted By: singingknowles
Date Posted: Feb 26 2009 at 5:24am
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Nancy,
Thank you for all your research. You are wonderful!! Just one more question, I went for my radiation simulation today and my radiologist said triple negative was really good. I am so confused. My nurse navigator said I will definitely need chemo and lose my hair. Possibly not lose any work time though. I know it is different for everybody but what is the average on women having to lose work time because of side effects. I am a school secretary registrar in a very busy guidance office.
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Posted By: billie
Date Posted: Feb 26 2009 at 6:34am
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Hi Kirby, Nancy,singing and all,
Back around 10 months ago we had a big discussion about this test being done for triple negative.And yes some of the ladies were fortunate enough to have gotten this done.When I finish this post I am going to bump this discussion up.Connie also has a lot of knowledge about where trip negs could get this done way back then.The big grip back then was that you had to have knowledge of this and you had to be the one to ask for this to be done.In order for them to have done this test they have to have (what is called)a live speciman.It could not be frozen and arrangments had to be made in advance of the surgery.If my memory serves me right,this test will tell the onc. exactally what type of chemo(in advance) will work for you,along with many other things.
So, singing,if I were you,I would be so so thrilled that your dr. is so up on things that he did this for you without you having to insist that it be done.This says to us all.Maybe a small handful of these dr.s are beginning to take notice about trip neg and discovering that this sub type of breast cancer is indeed not your standard breast cancer and that they need all of the help that they can get to help their patients fight it.
I am now going to go and find this and once again bump it up.Lots os Hugggggsssss Billie
------------- Billie posting for sis Betty/67/caucasion female/diagnosed 2-27-08/gradeIII/7mm/invasive ductal carcinoma/T N /clear margins/node neg/4 X's taxotere-cytoxan/36 rads/7-08 PET/CT double image/no cancer
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Posted By: billie
Date Posted: Feb 26 2009 at 8:19am
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Hi Ladies ,
I cannot bring up the conversations that we had back in April of 08,it is too far back and wiped away..I so regret that, because I have to tell you that back in those conversations,in doing research for my sister,you cannot believe the amount of information that I was able to gather from the members on this foundation.
One of the members that had the testing done is named EWK Seattle,however there was also several more.She had her chemo fx test done at Precision Therapeutics,Inc.There is also the DR. Larry Weisenthal clinical cancer testing labrotories and research facilities.
The reading of the tumor is for several reasons,but it is to tell you what chemo is best suited for you and also if there is a possibility of a recurrence.For those of you that are maybe interested in this,maybe Connie, once again can tell where the safest one is for triple negative.
Lots of Huggggssss Billie
------------- Billie posting for sis Betty/67/caucasion female/diagnosed 2-27-08/gradeIII/7mm/invasive ductal carcinoma/T N /clear margins/node neg/4 X's taxotere-cytoxan/36 rads/7-08 PET/CT double image/no cancer
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Posted By: Nancy
Date Posted: Feb 26 2009 at 8:42am
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Singing,
They say it is actually "good" to be HER2-, as the HER2+ is more aggressive. But...the bc+ has meds to take after cheo...Tamoxifen. Now however, they say that after the 5 years of Tamoxifen, it can "turn on you". They say it is going to TN.
Lori teaches second grade and taught all through her treatments. She was off on Fridays, the day of chemo and then the folllowing Monday and Tuesday. First chemo she went back on Tuesday, and thought she was not going to make it home. You will have to play it by ear, as everyone responds differently to the chemo. Since Lori's tx's were every 3 weeks, she did not really miss that many days. Also, there were holidays which fell on Mondays.
Lori was in great shape physically, so perhaps that helped her. I haven't checked to see what chemo you are having.
Many hugs,
Nancy
------------- Nancy
DD Lori dx TNBC June 13,2007
Lumpectomy due to incorrect dx of a cyst
mastectomy July 6 2007
chemo ACT all 3 every 3 weeks 6 tx Aug-Nov
28 rads ended Jan 2008
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Posted By: outnumbered
Date Posted: Feb 26 2009 at 9:13am
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Some doctors are very thorough and run all kinds of base line tests. Other's, like my ex-oncologist, think they have crystal balls and can predict the outcomes, and do not even bother with tests. I think mine had a magic eight ball. Although it is exhausting to go through all this, please try and be patient while you doctor tries to get a complete picture of your individual bc.
------------- ~Sara
DX @ age 40 6/24/08 Stage 1 Grade 3 BRCA1+ 187delAG
BMX (nipple-areola-sparing) 8/5/08
Redo BMX (remove nipple and areola) w/ Lat Flap 7/6/09
BSO 9/3/09
NED since 08/05/2008
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Posted By: outnumbered
Date Posted: Feb 26 2009 at 9:18am
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Sorry I reversed the order I viewed posts and was responding to Sining's first post. A bit of a delayed reaction.
------------- ~Sara
DX @ age 40 6/24/08 Stage 1 Grade 3 BRCA1+ 187delAG
BMX (nipple-areola-sparing) 8/5/08
Redo BMX (remove nipple and areola) w/ Lat Flap 7/6/09
BSO 9/3/09
NED since 08/05/2008
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Posted By: singingknowles
Date Posted: Feb 26 2009 at 2:11pm
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Ladies,
I can't thank you enough for all your help. I definately came to the right sight for information. I will be here for the long haul. Thank you again for the encouragement and knowledge!!!!!
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Posted By: billie
Date Posted: Mar 02 2009 at 9:12am
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HI singing,
Just so we can also have this info.Perhaps you can ask your oncologist the name of the company where he sent your testing to be done.Would be much appreciated.Your onc. could possibly have connections that we are not aware of.Nevertheless,if I were you I would be very pleased with the fact that he is ordering any procedures out there,available to public or not,to include in your treatment.Best of luck and many many Hugggggssss Billie
------------- Billie posting for sis Betty/67/caucasion female/diagnosed 2-27-08/gradeIII/7mm/invasive ductal carcinoma/T N /clear margins/node neg/4 X's taxotere-cytoxan/36 rads/7-08 PET/CT double image/no cancer
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Posted By: singingknowles
Date Posted: Mar 04 2009 at 3:43pm
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The company is Genomic Health, http://www.genomichealth.com - www.genomichealth.com or http://www.oncotypeDX.com - www.oncotypeDX.com Genomic Health, Inc., PO Box 60000, San Francisco, CA 94160 Ph: (866) 662-6897
and info about the test at http://www.mytreatmentdecision.com - www.mytreatmentdecision.com
The company called me last week to let me know that they received the order, told me some info about the test, and informed me that they already checked with my insurance company and it would be fully covered. She then asked if I wanted them to proceed with the test. Talk about efficient. I was very impressed with the womans knowledge and compassion.
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Posted By: krisa
Date Posted: Mar 04 2009 at 4:43pm
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My tumor was sent there and was rejected...TNBC.
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Posted By: billie
Date Posted: Mar 04 2009 at 7:29pm
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Hi Singing,
Boy, has a can of worms been opened.If you get a chance check in on the bumped up topic "Conflicting Triple Negative Reports".At the last part of this topic ,we thought that we had figured this out.And the question being that?These places do not do this testing on triple negative BC.Supposedly they only do this if the tumor is large and the lady is to have chemo first in order to shrink the tumor and then have a lumpectomy.
Now,singing .I want to make sure that I am not scareing you.So please do not think that your tumor may be larger or anything like that.We ,on this foundation are having a discussion as to when this testing can be done and if the testing does include triple negative also.
I have always said that if I should happen to get BC,I would absolutely wish to have the chemosensitivity testing done.
My hope is that you will try to get as many questions asked that you can in order to help us find out why some can get this done and some not.Believe me when I say this.Asking questions will not have any reason why yours should not get done.Yours is a done deal,especially since your ins. is going to pay for this to be done.Please keep us informed.
Lots and Lots of Hugggggsssss Billie
------------- Billie posting for sis Betty/67/caucasion female/diagnosed 2-27-08/gradeIII/7mm/invasive ductal carcinoma/T N /clear margins/node neg/4 X's taxotere-cytoxan/36 rads/7-08 PET/CT double image/no cancer
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Posted By: kirby
Date Posted: Mar 04 2009 at 7:37pm
It states right on their site testing is only done on stage 1, hormone receptor + cancers.
------------- kirby
dx Feb. 2001. Age 44 Lumpectomy
2cm. no nodes stage 1 grade 3
4 rnds AC, 35 rads
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Posted By: billie
Date Posted: Mar 04 2009 at 7:54pm
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Oh I don't know Kirby what is really happening.Perhaps these people do not fully understand that singings tumor is triple negative.Or maybe it is being sent there to confirm exactally what subtype it is.
Hopefully,singing can find some answers for us.But I also want to make sure that none of us scare her.Lotts of Hugggssss Billie
------------- Billie posting for sis Betty/67/caucasion female/diagnosed 2-27-08/gradeIII/7mm/invasive ductal carcinoma/T N /clear margins/node neg/4 X's taxotere-cytoxan/36 rads/7-08 PET/CT double image/no cancer
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Posted By: cg---
Date Posted: Mar 05 2009 at 12:54pm
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Oncotype testing is only done for hormone positive breast cancers - stage I.
They will reject our tumors because they are hormone negative.
Just my thoughts on the subject.
Connie
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Posted By: singingknowles
Date Posted: Mar 05 2009 at 2:20pm
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I have already accepted the fact I will need chemo and rad. I am really not scared about that, just confused. I was questioning why the onc. ordered the test in the first place. He did it as soon as the HER2 came back negative. I have the path. report that states ERneg, PRneg. My tumor was only .9cm, grade 2, stage 1, node neg., clear marg. It has been one week today and I have not heard that it was rejected. It takes 10 - 14 days for the test to be completed and reported.
I go to the med. onc. tomorrow. I will find out more info and report back tomorrow night.
Anyone try Aloxi for nausea? I just received info in the mail about it.
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Posted By: gpawelski
Date Posted: Jun 27 2009 at 7:07am
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Molecular & Cellular Assay Tests
The Oncotype DX (genetic assay) is another test to enhance the ability to distinguish between low risk and high risk patients. Patients in the high-risk group, who would benefit from chemotherapy can then be pre-tested to see what treatments have the best opportunity of being successful, and offers a better chance of tumor response resulting in progression-free survival, while those in the lower-risk groups can be spared the unnecessary toxicity, particularly associated with ineffective treatment.
This laboratory test, as well as the others, is a tool for the oncologist. The oncologist should take advantage of all the tools available to him/her to treat a patient. And since studies show that only a minority of patients do respond to chemotherapy that is available to them, there should be due consideration to looking at the advantage of molecular and cellular assay tests to the resistance that has been found to chemotherapy drugs.
And, according to the National Cancer Institute, those who benefit substantially from "targeted" drugs make up a fairly small proportion of cancer patients. Conventionally, chemotherapy is recommended according to guidelines generated by statistical data. According to the FDA, the response rate of a patient that follows these guidelines is approximately 20%. What if you are one of those few?
Cell Culture (cell-based) Assays can report to a physician specifically which chemotherapy agent would benefit a high risk cancer patient by testing that patient's live cancer cells. Drug sensitivity profiles differ significantly among cancer patients even when diagnosed with the same cancer. Knowing the drug sensitivity profile of a specific cancer patient allows the treating oncologists to prescribe chemotherapy that will be the most effective against the tumor cells of that patient.
Every breast cancer patient can have her own unique chemotherapy trial based on consultation of pathogenic profiles and drug sensitivity testing data. Research and application of these tests are being encouraged by growing patient demands, scientific advances and medical ethics. These tests are not a luxury but an absolute necessity, and a powerful strategy that cannot be overlooked.
Improving cancer patient diagnosis and treatment through a combination of cellular and gene-based testing will offer predictive insight into the nature of an individual's particular cancer and enable oncologists to prescribe treatment more in keeping with the heterogeneity of the disease. The biologies are very different and the response to given drugs is very different.
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