Oncotype DX test minimal help for hormone-receptor-negative

The Oncotype DX test can predict the likelihood of recurrence in early stage invasive breast cancer, but it has one flaw: It works with hormone-positive cancers, not hormone-negative. Once again we’re the wallflowers at the breast cancer prom, with the docs dancing with the girls with the popular cancer.

Still, the test might be worth asking for (check to see if your insurance covers it first) because it will include your estrogen (ER) and progesterone (PR) receptor status. This is factored into the likely rate of recurrence and is used to determine the potential benefit of chemotherapy and tamoxifen.

A sample test nicely demonstrates how pathologists define ER and PR scores. The higher you are in the positive range, the more you will benefit from tamoxifen. I did not have a graph like this to clarify my readings. I just got a generic “ER-negative; PR weakly positive” statement. When I finally came to my senses and realized I needed more data, I called the lab to determine how weakly positive I was. They said they no longer had the sample and had just the information I already had on my pathology report. They gave me their definition of “negative” as being less than 50 percent of the sample. It would have been great to have had the additional data this test provides, even if it could not determine the rate of recurrence of my cancer.

My husband, though, reminds me often: My cancer is not coming back. Period.