What is Oncotype Dx?
There are over 25000 genes in human beings. Several of these genes were analyzed in breast cancer patients undergoing clinical studies to identify a group of 21 genes that were most strongly correlated with cancer recurrence. Studies done on these genes in breast cancer tissue became the basis for developing the Oncotype Dx test to determine what is called a Recurrence Score.
How do you use the information from this test?
The Recurrence score determines the risk of patients developing a recurrence of their breast cancers over the following ten years.
This information also helps cancer physicians choose the most appropriate form of treatment including the ability to determine the likely benefit from chemotherapy.
Thus, this test not only allowed physicians to be able to predict the behavior of these cancers better but also allowed a more accurate estimation of the beneficial effects of adding chemotherapy.
Do we need to perform this test on ALL patients diagnosed with breast cancer?
Traditionally, physicians have used breast cancer characteristics such as size of the cancer, receptor status, and lymph node status to estimate how likely their cancer is to come back, and to help determine treatment decisions including the need for chemotherapy. These characteristics are still helpful in choosing a course of treatment, but the additional information provided by the Oncotype DX test has helped refine the treatment choices that can be offered to these patients.
We do not need to perform this test on ALL patients diagnosed with Breast cancer. Oncotype Dx for breast cancer was initially used to help patients with stage I and II cancers who do not have lymph node or distant spread of their tumors and who have tumors that were positive for estrogen receptors. Traditionally, these patients have been treated with such medications as Tamoxifen alone. It was felt that many of these patients failed this form of treatment and could have been served well with the addition of chemotherapy in addition to Tamoxifen. Oncotype Dx thus allows identification of this subset of patients who could benefit with the addition of chemotherapy while sparing others from it.
Newer studies are suggesting similar predictive and prognostic value in those patients who have early stage, estrogen receptor positive breast cancer who already show cancer spread to lymph nodes in the axilla.
There is no benefit of this test in patients with non-invasive breast cancers and those who have obvious evidence of breast cancer spread.
In summary: Oncotype Dx is a simple test that has had a profound impact on our ability to predict the prognosis as well as to tailor make more precise treatment decisions in patients with early stage breast cancers.
This test is but a harbinger of things to come in the world of cancer care where testing cancers at a molecular level for each individual patient will lead to further refinements in our ability to plan effective treatment strategies for them.
Dr. Kumar is a board certified Radiation Oncologist who is co-founder of a private practice group in Florida. He has over 17 years experience dealing with cancer patients including several members in his own family who have been afflicted by this disease.
His philosophy of managing patients is through a unique holistic approach that takes into account the wishes and needs of patients and their families. He believes that any battle is won at the level of the mind first before the body goes into action to win the war. His website http://curingcancerofthemind.com/ reflects this philosophy.
He is always available to help any patient with questions regarding cancer and radiation therapy and can be reached at 772 293 0377.
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