Image Source: / cooldesign

Image Source: / cooldesign

The Oncotype DX Test and Some Controversy

Most in the medical field would agree: early detection of breast cancer saves lives.  But how do doctors really know which treatments will be best to prevent the return of your cancer?

The Oncotype DX is a diagnostic test that helps your oncologist determine which treatment plan will most effectively prevent your cancer from returning (recurrence) or help to control your disease.

In order to be considered for this test, patients must have a diagnosis of estrogen-receptor positive (ER+), or estrogen-fueled breast cancer, be Stage 1 or Stage 2 and have no lymph nodes with cancerous cells, information that isn’t available until your lump has been biopsied.

When I went through breast cancer in 2004, this test wasn’t available. It wasn’t until 2007 that the test was trialled.

What is the Oncotype DX?

The Oncotype DX test is a tumor profiler. It examines samples of tissue from your tumor and rates it for a specific set of genes that can influence the likelihood of recurrence within 10 years after your original diagnosis.  The result of the test is reported as a number between 0 and 100, known as the Recurrence Score® result.

The Recurrence Score

All of these test results make it easier for your oncologist to provide you with a diagnosis, but the genetic information (along with all of the other diagnostics) gives a clearer picture of whether or not your particular tumor will respond to chemotherapy to prevent any recurrence.

Your recurrence score will be based on the genetic expression of 21 genes, 16 of which are cancer-related, and 5 of which are reference genes. The genes are grouped by function: proliferation, invasion, hormone receptors (estrogen and progesterone), and growth factors. Each person’s test results are unique, and will fall into one of three categories – low risk, intermediate risk, and high risk.

Those who have a low risk of recurrence may not need any chemotherapy but may be offered hormone therapy as a follow-up treatment after surgery. Those in the intermediate to high-risk categories may be offered chemotherapy as well as hormone therapy to further reduce a risk of recurrence. There are many other factors such as age, tumor grade, hormone receptor status, etc. that will be considered by your oncologist before a treatment plan will be put together, but research has shown that results from the Oncotype DX test are a very strong predictor for recurrence.

The Controversial Part

Medicare and several private health insurance companies will help cover the cost of an Oncotype DX test. Check with your insurance provider to find out if you are covered for this test. The current list price for the Oncotype DX is $4,000.00 and it’s done by one company, Genomic Health.

This upsets me (and a whole host of others, let me tell you!).  There is no way that test should be so expensive.  It’s like holding us hostage – pay up or you aren’t going to know exactly which therapies you should be given. It’s absolutely disgusting.  I invite your comments below.


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