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Interesting thread. Here is my pathology:
IDC 1.3 cm, 9mm invasive, 10% DCIS, ER+ 80%, PR+ 50%, Her2+++ by IHC, Ki-67 11% (borderline normal), grade 2, Bloom-Richardson score 7, 1 positive margin; rexcision for positive margin (no additional cancer found) and sentinel node biopsy, SNB negative, stage 1, dx at age 52, postmenopausal
My oncotype score was 44, which translates into a 30% risk of distant recurrence at 10 years (95% CI: 22%-37%). However, the report also states:
"Test results should be interpreted using the information in the Clinical Experience section below, which applies only to patients consistent with this clinical experience." (emphasis added)
The Clinical Experience section reads:
"The following study results are from a clinical validation study with prospectively-defined endpoints involving 668 patients. The patients enrolled in the study were female, stage I or II, node negative, ER-positive and treated with tamoxifen." (emphasis added)
So, basically, the score is only directly applicable if you are taking only tamoxifen. Seeing as tamoxifen monotherapy has been shown to be a potential agonist for post-menopausal Her2+ bc, I question whether this result is reflective partially of that property or something else. Bottom line, there is no way to tell, and I regret having the test in light of this plus the fact that my insurer did not contract to pay for the testing until one month after my test was done and is still contesting payment for it.
The TailorX Trial that is currently under way to test the effects of chemo vs. chemo + hormonal therapy in the intermediate score group is limited to Her2- patients, which I also consider significant. I think the jury is out on how well this test works in Her2+ patients.
Sorry for the thread drift - hope this wasn't "TMI" !
Hopeful
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