When the doctor tells you that you have breast cancer, you must have felt a lot of fear and shock. 'What do I do now?', 'What kind of medicine will I be given?', 'Will I have chemo ?' Many questions must have come to mind. We know that fighting cancer is not an easy journey. But today's medical science has advanced a lot. At a time like this, today we are talking about a special test that helps doctors decide exactly what treatment to give you.
What is Oncotype DX?
Simply put, Oncotype DX is a special test that looks in depth at your breast cancer cells. It's not a regular blood test. It uses a piece of cancer tissue taken from a biopsy to confirm your cancer or from surgery to remove the tumor.
This test looks at the activity of certain genes inside cancer cells. Just like all of our cells, cancer cells also have genes. These genes determine the behavior of the cancer, that is, how severe it is, how fast it can spread, and how likely it is to come back after treatment.
The Oncotype DX test focuses on 21 genes, which is why you may hear it called a “21-gene signature” test. By analyzing these gene patterns, doctors can learn a lot of important information about your cancer.
Who is recommended to take this test?
This test is not necessary for every breast cancer patient. Your doctor is more likely to recommend this test if you have any of the following conditions:
- If you have early stage cancer (Stage I or II): This means the cancer has not yet spread to distant parts of the body.
- If the cancer is estrogen-receptor positive (ER+): This means that the cancer cells grow because of the hormone estrogen produced by your body. This type of cancer is usually treated with hormone therapy .
- If the cancer has not spread to the lymph nodes in the leg.
Additionally, this test can sometimes be done for people with very early stages of cancer called DCIS (Ductal Carcinoma in Situ) , to help decide whether radiation therapy is needed.
The most important thing is that the biggest help from this test is the guidance you get in deciding whether or not you need chemotherapy treatment in addition to hormone therapy.
How do you read the test score?
The Oncotype DX test gives you a “Recurrence Score” between 0 and 100. The higher this score, the higher the risk that the cancer will come back after treatment. However, the way this score is read will vary slightly depending on your age.
| Score Range | Risk | Possible Recommendation |
|---|---|---|
| 0 – 25 | Low risk | Hormone therapy alone may be sufficient. There is very little chance of additional benefit from chemotherapy. |
| 26 – 100 | Higher risk | The risk of the cancer coming back is high. Chemotherapy may be recommended as well as hormone therapy. |
| Score Range | Risk | Possible Recommendation |
|---|---|---|
| 0 – 15 | Low risk | Hormone therapy alone may be sufficient. There is little chance of additional benefit from chemotherapy. |
| 16 – 20 | Low-medium risk | Chemotherapy may provide a small benefit, but you should discuss with your doctor whether the benefit is worth it compared to the side effects. |
| 21 – 25 | Medium risk | The benefits of chemotherapy may outweigh the risks of its side effects. You should discuss this with your doctor and make a decision. |
| 26 – 100 | Higher risk | The risk of cancer coming back is high. Chemotherapy is more likely to be recommended along with hormone therapy. |
Should this sign alone determine treatment?
Absolutely not. This is very important. The Oncotype DX score is only one strong factor to help you make a decision. Your doctor will take many other factors into account before developing the best treatment plan for you.
For example:
- Tumor size
- Tumor grade
- The number of hormone receptors in cancer cells
- Your age and overall health
All of these factors come together to make the final decision. Therefore, this test report is just one tool that can help your doctor create the best treatment plan for you.
Are there other genetic tests like this?
Yes, there are several other genetic tests used for breast cancer. But the most widely used is still Oncotype DX. Let's briefly learn about the others.
- MammaPrint: This tests for 70 genes. It helps predict the risk of cancer spreading outside the breast. It can be used for both ER+ and ER- types.
- Mammostrat: This tests 5 genes and measures the risk of early-stage hormone-receptor positive breast cancer coming back.
- Prosigna: This is used for hormone-receptor-positive breast cancer in postmenopausal women. It analyzes 58 genes and predicts the risk of the cancer coming back elsewhere in the body within 10 years.
All of these are advanced tests. Your doctor will decide whether you need one of these and which is most appropriate.
Take-Home Message
- Oncotype DX is a special test that examines the genes of breast cancer cells to help determine the risk of cancer recurrence and whether chemotherapy is needed.
- This is done with a piece of cancer tissue taken from a biopsy or surgery, not from blood.
- This test is not needed for everyone. It is most commonly used for cancers that are Stage I/II, ER+, and have not spread to the lymph nodes.
- The test score is only one part of the treatment plan. Your doctor will consider many other factors, such as the size of the cancer, its severity, and your age.
- If you have any questions or concerns about this, be sure to talk openly with your doctor . He or she will definitely help you choose what is best for you.
Oncotype DX Sinhala, Breast Cancer, Chemotherapy, Cancer Genetic Testing, Cancer Recurrence, ER Positive Cancer , Cancer Treatment
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