Tuesday 24 September 2019

Oncotype DX Breast recurrence score

Its been a while since I blogged anything about my breast cancer journey you might ask why? it seems, in the beginning, everything was one appointment after the next for my MRI scan multiple biopsies then, following on from all of that prodding and poking my surgery for my mastectomy and now nothing well thats what it feels like to me anyway.

Last week I got my results from my mastectomy, some good news some not so good news, let me tell you the good news first I have no lymph node spread which is great, hopefully that means that the breast cancer won't randomly turn up in some other part of my body in years to come, the consultants can never say never but I am staying positive. The consultant thinks that she has managed to get rid of all of the breast cancer, the margins the consultant says are clear so technically I should be cancer-free which I'm really happy about. Now the not so good news the monster that was taking over my breast was four cms instead of three cms which was the size the MRI scan gave, I was actually quite surprised by this as I thought that MRI scans were as accurate as accurate could be, there were also smaller satellite masses one was half a cm the other was one cm in the words of the consultant it was a very busy breast.

I thought at this appointment I would have a treatment plan at least so I know what's happening next but the next bit was hard to swallow they are sending my breast tissue to California seems hardly fair that a part of me is visiting the states without me! Its going to the states because its one of the only places in the world that will look at all the cancer cells and they will then give me an accurate number of my reoccurrence, meaning how likely it is that the breast cancer will return then based on this the consultant will make a decision on my next stage of treatment.

OncotypeDX testing what is it? 

All breast cancers are different and some carry hormone receptors some don't my breast cancer was HER2 negative and Oestrogen positive stage 2

To be considered for OncotypeDX testing you have to fall into a specific category:

  • Are newly diagnosed with early-stage invasive breast cancer. 
  • Have cancer cells that are ER+ (Oestrogen positive)
  • Have cancer cells that are HER2 negative.
  • Are either lymph node-negative or have up to three lymph nodes that are positive.   

As you can see I fall completely into the specific guidelines for the testing the test takes around two weeks to complete and The Oncotype DX test is a molecular diagnostic test that analyses the individual biology of a breast cancer tumour by examining the activity of 21 genes in the tumour tissue. At the end you get given a score between one and one hundred the lower the score the less the need for chemotherapy and the less likely my breast cancer is going to reoccur, the higher the score the consultant may recommend chemotherapy alongside hormone therapy and it will tell me that there is a high chance the breast cancer will come back. however it's not inclusive the consultant will discuss this with me at my appointment and it will be a mutual decision between us as to what is the right thing for myself once the results are in.

Scores made simple: 

  • Women with a score of 0 to 25 who are over the age of 50 won’t get any benefit from having chemotherapy in addition to hormone therapy.
  • Women who have a score of 26 or above and are over the age of 50 are likely to benefit from having chemotherapy in addition to hormone therapy.
  • Women with a score of 0 to 15 who are aged 50 or under won’t get any benefit from having chemotherapy in addition to hormone therapy.
  • Women who have a score of 16 or above and are aged 50 or under, your specialist will discuss your test result with you to help decide if you’re likely to benefit from chemotherapy.

That is the simplest way to explain the test and how it works for me now it's a waiting game to find out what the future of treatment holds for me I am still eagerly awaiting my appointment from the oncologist and then there is the breast reconstruction to consider, but to be honest until all the treatment side of things is out of the way its not even within my thoughts its not priority. Cancer isn't something that you seem to be able to think about long term well I don't find it easy to think to the future you just have to take each day and appointment as it comes and for me the worst part is waiting but I can't change what the future holds I believe its already written. 



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