Following a breast cancer diagnosis in July and bilateral mastectomy in August, I had Oncotype DX test performed on the three tumors I had, all in same breast. Oncotype scores were 10, 9, and 6. My highest 10-year recurrence risk is 7%, with Tamoxifen. I would love your input on a few issues:
--Is it worthwhile to also get a Mammaprint?
I realize being in the Low category of Oncotype means it's unlikely that Mammaprint will return a high risk score, but I also know that every cancer is different, and I want to ensure I am doing everything I can to reduce recurrence risk. (I.e., if chemo is helpful, I want to do it.) My oncologist suggested the Mammaprint would be a waste of my money, but my ki67 was 16% on two of the tumors, so I am concerned that the Oncotype may not be fully accurante in predicting my recurrence risk.
--Efficacy of ovary shutdown to reduce estrogen?
At 46, I show no signs of menopause. I understand shutting down my ovaries may further reduce my recurrence risk. My oncologist suggested we re-visit after I've been on Tamoxifen a few months, to see how I do on Tamoxifen first. I've been on Tamoxifen for almost two weeks, with no side effects thus far.
Thank you in advance for your advice.
P.S. This site is a wonderful idea, and I am keen to support.
Reply # - October 7, 2014, 01:01 PM
First thank you so much for
First thank you so much for the compliment, as a caregiver I holey agree there's nothing else quite like Grace and for that reason we have to keep it running, so thank you too for the support, financial and or word of mouth/media.
carola, I'm sorry you're going through this. I will contact our breast cancer specialist for comment and I've pasted links to discussion on the subject. http://cancergrace.org/search-results?q=Mammaprint
I hope all is well,
Janine
Reply # - October 7, 2014, 01:21 PM
Generally either Oncotype or
Generally either Oncotype or Mammaprint are done, not both. Many insurers won't pay for both, particularly in a case like yours where all 3 tumors were tested and had low scores. As a result, there aren't much data to say what to do if your Oncotype score is low but your mammaprint is high. I therefore would be hesitant about doing Mammaprint at this point. In regards to ovarian ablation, the data are evolving and more data, specifically regarding tamoxifen plus or minus ovarian ablation are likely to come out soon. I think your oncologist's approach of waiting to see how you tolerate tamoxifen is reasonable and there may be more data to inform your decision by then.
All the best,
Dr Cianfrocca
Reply # - October 7, 2014, 02:46 PM
Dr. Cianfrocca,
Dr. Cianfrocca,
Thank you for your response. This is helpful.
One more question, if I may: Does the ki67 score (mine of 16%) generally have no bearing when an Oncotype DX test is performed? That is, if Oncotype result is Low, is ki67 in intermediate range not considered?
Reply # - October 7, 2014, 03:11 PM
As a general rule, assuming
As a general rule, assuming that Oncotype was performed in an appropriate patient (hormone receptor-positive, HER2-negative, lymph node-negative), that is correct.
Dr Cianfrocca