Oncotype Test for Her2+?

[Hopeful]

Although I have not participated, I have lurked here for the last two months and been very impressed with the level of the discussions (most of which I can keep up with, but some over my head). Thank you all for the wonderful support you provide along with all that knowledge. My question pertains to how useful the Oncotype test is for Her2. I have read several posts where oncologists have reccommended against getting the test, as the results are "skewed" for Her2+. It has also been suggested in several places that Taxomifen can actually feed some Her2+ ER+ tumors, making the cancer worse. Has anyone's doctor addressed this issue in light of the fact that the Oncotype score is validated with a group of patients treated with Tamoxifen? It would seem to me that such a comparison would also cause the results to be higher. In my case, the score came out high (41); however, I am strongly ER+PR+, my B/R score is a 7 (intermediate) and my Ki-67 is 11, described as "borderline" which I have recently learned is borderline low (low is >10). I feel the pathology results and the Oncotype score are inconsistent.

If anyone is interested in how the Oncotype score is arrived at, go to the article at http://breast-cancer-research.com/content/8/3/R25and click on Figure 1. It seems the Her2 and Proliferation Group genes get the most "weight" in arriving at the score.

Thanks everyone for your thoughts.

Hopeful

[panicked911]

All I can tell you is that I have consulted with three differet oncologists from major cancer centers in NY and they all said the same thing - b/c strongly triple positives( her2, er, pr) are such a small subset of the breast cancer population - that much reseach has not been done specifically for this subset. Typically, the bc cells of a strong triple positive are not as aggressive as those of Her2 only. The er.pr factor typically slows them down. With that said, when the Oncotype DX formula is applied to get a reoccurance rate, the HER2 factor is weighted to heavily for the triple positives - treated the same as hers er/pr-. Thus, the results are skewed. That is not to say that that there could still be a high risk of reoccurance for a triple positive. Bottom line is that there is no accurate way of testing and for those of us whose insurance won't pay for it, $3,500 for an inaccurate test does not seem to make much sense.
As for the tamoxifen piece, itappears to work for the strongly triple positives - however it does not appear to work as well as the AI's. Thus for those of us who are either menapausal already or have decided to go the ovary ablation route, AI's are the next line of defense againsta reoccurance - at least during the first 5 years -

Hope this helps

Susanne

[Hopeful]

Thanks, Susanne, that does make sense. I am eligible for AI's, and will be starting Femara after my radiation treatments are finished.

Hopeful.