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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
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