Oncotype Dx testing

Oncotype Dx testing

Hi,

I am Santhosh from southern part of India.

My mother undergone a breast cancer surgery last december and after that doctor suggested to do three cycles of Chemo for safer side , but i am in confused state to go with chemo or not. Then he said to do Oncotype Dx  testing for our confirmation about chemo testing. I could not able to find the centres which do Oncotype dx testing. Can you people help me with the various test which I could decide to go with Chemo .

My mother is 61 yrs old affected by Infiltrating duct carcinoma breast with size 4x3x3 cm and Grade II ,

 ER +++ 

PR ++

Her2neu Negative

 

I have also attached the biopsy report and pathological finding after surgery.

Can you suggest me some ideas that will clear my mind and to choose the proper practice.

You can also suggest me through my mail sanshsanthosh@gmail.com

Thanks in advance.

Regards,

Santhosh.

4 Replies

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  • The Oncotype DX test is a genomic test that analyzes the activity of a group of genes that can affect how a cancer is likely to behave and respond to treatment. 

    I think its very costly app 1.50 Lacs - you can search the same topic which was replied by Dr Sumeet Shah one year back

    Copying the same for you

    Oncotype DX can be done. The samples are sent to their labs in US by their representatives here.

    Oncotype DX assesses certain genes in the tumour sample and gives an idea of the chance of recurrence. Following conditions have to be satisfied:

    ER / PR Positive and HER2 Negative tumours only (not to be done for TNBC or HER2 positive tumours)

    Nodes MUST be negative (not applicable for node positive). For node positive, chemo is a MUST

    If a lady has a relatively smaller tumour size, which is ER positive / HER2 negative and node negative, and we are not too sure whether to give chemo or not, then we add Ki67 to this. This is a very crude way of decision making, but Ki67 costs some Rs. 700 and Oncotype DX costs more than 1.5 Lakhs! If Ki 67 is high (indicating a fast tumour turnover time), we definitely give chemo. If Ki 67 is low and other factors are favourable (No LVE / PNI / Lower grade tumour / Nodes negative etc...), we explain the situation to the patient and relatives and taking into factor the age of the patient, we counsel them about benefit of chemo and risks of it, for this age and stage, and then make a decision.

  • Oncotype DX is the clinically validated 21 gene assay and your mother does seem to be eligible for this test.

    If the score is low, she may be spared the agony of chemotherapy.

    The Ki67 is not clinically validated but many clinicians do use it. The default option for her will be to have Adjuvant Chemo provided she is fit enough for this treatment as determined by her cardiac, renal, liver profiles.

    If u can àfford that test...good enough.

    But if u can't, then safest option would be to go ahead with chemo.

    All the best.

  • Both above have already answered your question.

    As for suggestion of ideas, its a very broad topic and if were to write, it would take tens and twenty pages on Microsoft Word. And we cant suggest anything without actually assessing the patient. So, my sincere suggestion would be that you must sit with your Oncologist and decide the further line of treatment. If you are still not sure, you can go for one more opinion with some other Oncologist.

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