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1. What is the Oncotype DX test?
2. Who is Oncotype DX for?
3. Why is it used?
4. How does it work?
5. Oncotype DX score
6. Availability and cost
7. Oncotype DX Breast DCIS Score test
Oncotype DX is a test that predicts how likely breast cancer is to spread to somewhere else in the body (secondary breast cancer) within 10 years of diagnosis, in people who will be taking hormone therapy for at least five years.
The test is suitable for people recently diagnosed with early stage invasive breast cancer that:
Sometimes the test may be considered for people whose breast cancer affects one to three lymph nodes under the arm.
The test is not suitable for people whose breast cancer is oestrogen receptor negative or HER2 positive.
Your specialist may recommend the Oncotype DX test if the benefit of chemotherapy for you is less clear.
Chemotherapy may be given after surgery to reduce the risk of breast cancer coming back in future.
Whether you’re offered chemotherapy depends on a number of features of your breast cancer. These include:
For some people the benefit of chemotherapy is clear, but for others it’s less clear.
The test is done on a small amount of breast cancer tissue already removed (for example during a core biopsy or surgery).
The tissue is sent to a laboratory in the USA, where the test is carried out. The test looks at groups of genes found in breast cancer.
The results are given separately from your pathology report and are sent to your specialist within 10 to 14 days.
If your specialist has recommended you have hormone therapy before surgery, the test must be done on the tissue removed by a core biopsy, before you start hormone therapy.
The test gives a score, known as a Recurrence Score, from 0 to 100.
The higher the score, the more likely breast cancer is to come back and the more likely you are to benefit from having chemotherapy as well as hormone therapy.
Your specialist will use the score, along with other information about your breast cancer, to help decide whether chemotherapy would benefit you.
For women over 50:
For women aged 50 or under:
If Oncotype DX is suitable for you, it is usually available on the NHS across the UK.
Most private healthcare companies will also cover the cost of the test.
You can also pay for the test yourself, but your treatment team will need to order the test for you and will be sent the results to discuss with you. It costs around £3,000.
There’s a specific Oncotype DX test for people with ductal carcinoma in situ (DCIS) who have had breast-conserving surgery (also known as wide local excision or lumpectomy).
Oncotype DX for DCIS can predict the risk of the cancer coming back after surgery. The results of this test may help you and your treatment team decide whether you’re likely to benefit from radiotherapy.
It’s not routinely used on the NHS as there’s less evidence of its benefits for people with DCIS. Some private healthcare providers may cover the cost and you can also pay for the test yourself. For more information, talk to your treatment team.