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I ask for it, and my insurance pays for it. I suppose some oncologists feel there is not sufficient evidence yet to prove its value. Also, some oncologists don't like doing markers because of the reaction of the patient when they go up--fear mainly. They can go up for reasons not associated with cancer, although I still do mine from time to time.
It's a blood test, much like other markers, only this one is designed to determine likelihood of activity in HER2+ tumors.
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