Chemotherapy or No Chemotherapy- Learn About the Oncotype DX Test

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If you or someone you love is post-menopausal and diagnosed with stage one breast cancer, I suggest you speak the doctor about the Oncotype DX test. This test can help you and your doctor choose the best treatment for you. It can be one of the deciding factors on whether or not you need to have chemotherapy.  However, always remember, that the final choice lies with you and you want to be proactive.

According to WebMD, this test doesn’t require any additional procedures as it uses tissue taken during the initial biopsy or surgery. It measures 21 different breast cancer genes in the tumor sample.

The Oncotype DX helps to determine if you need chemotherapy treatment and is recommended for people who have Stage I or II invasive cancer and ER+ (estrogen receptor positive) cancer. The test looks for patterns that would suggest a more aggressive cancer, and that is likely to come back after treatment. The scores range from 0 – 100.  The higher the score, the higher the risk.

You also may be a candidate for the Oncotype DX if you’ve recently been diagnosed with DCIS and you’re having a lumpectomy to remove the DCIS. If you have been diagnosed with DCIS, they use a different scoring which is called, a DCIS score. Your doctor will look at your Oncotype DX score, your tumor size and grade, the number of hormone receptors in your cancer, and your age before recommending a treatment plan.

The more you know about your tumor, the more individualized the treatment can become.

Margret agreed to share her story with us:

“My original biopsy, after my positive mammogram results, showed stage one breast cancer in my right breast. Later during surgery, another tumor was found in the centennial node of my lymph glands. In all, 21 nodes were removed during the surgery.  My oncologist ordered the Oncotype DX Test to help me determine the course of cancer treatment to choose afterward. After surgery, the hospital sent the pathology (tumors) from the surgery to the Genomic Health laboratory.

Normally, when cancer is found in the lymph, the first treatment is 6 months of chemo.  Chemo has always terrified me because I saw what my mother went through during two courses of chemo.  She developed nausea and neuropathy to such an extent she could barely walk more a few steps because she couldn’t feel her feet on the floor. She lost her sense of taste, sex drive, weight, her skin tone changed, after the humiliating and debilitating symptoms, her hair falling out seemed like the least of the horror. 

After my breast surgery it took three weeks for the Oncotype DX report to come in, and when it did, the news that I wouldn’t have to undergo chemotherapy for six months was the most exciting news I could imagine!  I literally leaped for joy!

The Onco DX test showed that mine was tubular cancer, which is rare to about 1% of women with breast cancer. It sounded to me that I won the cancer lottery—because chemo is not recommended with tubular cancer.  My reoccurrence score was calculated from the gene expression results and the range is from 0 – 100.  My Oncotype DX Recurrence Score was 13 out of 100.  

Onco DX recommended the best course of treatment to prevent recurrence was to begin an anti-estrogen therapy.  My oncologist prescribed Exemestane 25 mg (also called Aromasin).  My doctor said that I might suffer some pretty severe reactions and if I couldn’t stay with it, we’d move onto something else, like Tamoxifen. Symptoms include osteoporosis/bone pain, hot flashes, high blood pressure, hair thinning, insomnia, nausea, fatigue, abdominal pain, depression, and pain.  I was pretty optimistic and sure with my current health and daily physical regime that I wouldn’t experience those symptoms.

My regime: exercise regularly, walk our dog, have a healthy diet that is wheat and almost sugar-free. Interestingly enough, I gave up sugar right after I was initially diagnosed 13 months ago.  I’ve been taking the medication for 8 months now and have not experienced any side effects.

Oncotype DX saved me from Chemo, which is the greatest gift I can imagine. I am so blessed to live in times when cancer seems tamable. It was so empowering to have choices and be able to live with my choice.  I had cancer, but cancer didn’t have me!”

Margret’s protocol would most likely have been much different had her oncologist not ordered the Oncotype DX test to analyze the activity of those 21 genes to help determine how her cancer would likely behave and respond to treatment.

The results of this new test can help you and your physician make a more informed decision about the course of your therapy.

I love science!

My Motto:  Suffering in silence is OUT!  Reaching out is IN!

Download my free eBook MENOPAUSE MONDAYS The Girlfriends Guide to Surviving and Thriving in Perimenopause and Menopause.

After struggling with her own severe menopause symptoms and doing years of research, Ellen resolved to share what she learned from experts and her own trial and error. Her goal was to replace the confusion, embarrassment, and symptoms millions of women go through–before, during, and after menopause–with the medically sound solutions she discovered. Her passion to become a “sister” and confidant to all women fueled Ellen’s first book, Shmirshky: the pursuit of hormone happiness. As a result of the overwhelming response from her burgeoning audiences and followers’ requests for empowering information they could trust, Ellen’s weekly blog, Menopause MondaysTM, was born.

  • I hope I nor anybody else I know ever has to go through something like this but if they do this test could be very helpful, I will be sure to recommend it and refer them to your blog if the time comes.

    • Thanks, Rena! Please share with the sisterhood!

  • No kidding, great science! Chemo is horrible and if it can be avoided successfully with a comprehensive test, terrific!

    • Science is going to help us individualize treatments.

  • Roxanne Jones

    Great article and information. It underscores how important it is to get care at a comprehensive breast care center where they’re more likely to offer all these resources in one location, and are up on the latest diagnostic and treatment protocols.

  • Avoiding chemo is life-saving for some. I had a pre-cancerous duct removed… I wonder what that means. I’m remembering this test, Oncotype DX, should I have to face another procedure. Great as always Ellen.

    • Nancy, the great thing about this test is that it doesn’t require any additional procedures as it uses tissue taken during the initial biopsy or surgery. Hopefully, you won’t need it, but now you have the information……..tuck it away – in case you or a friend may need it.

  • Lois Alter Mark

    Thank you, as always, for making us aware of important information – and making it easy to understand. I’m sure you’re saving lives.

    • Ahhhhh thanks, Lois. Information like this is so important as it helps to get more information about the tumor and individualize the treatment. The more the specialist knows about the tumor, the better! Thanks for sharing the info!

  • sue

    Chemotherapy is such a harsh treatment and I think many women don’t really understand all the types of treatment available to them. Thank you for highlighting this test which could be an alternative.

    • Please share with your networks. Many women are not aware of this test.

  • Technology is slowly changing cancer treatment. I do believe 100 years from now medicine will look back and say “can you believe they did that to people? they killed them with treatment!”

    • Tests like this are going to refine that one-size-fits-all kind of medicine. Margret sure was thrilled that this test was available!

  • Helene

    Thank you for sharing this important information. You are an amazing resource fir us.

    • Thanks, Helene. I am happy to help the sisterhood keep up on the latest info!

  • You are so in tune with all that’s new and interesting – this sounds like a really worthwhile alternative.

    • It is helpful to tuck this kind of information in the back of our minds – just in case!

  • Wonderful info. It’s good to know a person may not have to have chemo because it’s so debilitating.

    • If you need to have chemo it is vitally important to know that! If you don’t, it is also VIP to know that. Thanks for sharing the info!

  • CathyLynchLawdanski

    I learn so much from you! Hopefully I will never NEED this information, but if I do, you are challenging me to take charge and find all of the options there are!

    • Yes, Cathy! I want all women to be their own BEST health advocate.

  • Fascinating. I only wish this kind of test had been available back in the 1970s when my mom was diagnosed.

    • I know how you feel, Roz. So many women we know and love might have been able to benefit from this science. The good news is that the future is bright – new discoveries are happening all the time that are helping us individualize medical care.