Women with hormone receptor-positive breast cancer who have negative lymph nodes can take advantage of a test known as OncotypeDX. This test is used to estimate the risk of cancer recurrence in women diagnosed with early stage breast cancer. Results presented at the 2007 annual meeting of the American Society of Clinical Oncology said that the test results changed the oncologist's treatment decisions in about 31 percent of cases.

The test is useful in determining which patients are likely to benefit from chemotherapy in addition to hormonal therapy. It can predict the risk of a patient experiencing a recurrence up to ten years following diagnosis. The patient receives a Recurrence Score that ranges from 0 to 100, the higher the score -- the greater risk of recurrence.

This a great way for oncologists to be able to give individualized treatment -- instead of one size fits all. It's important to get chemotherapy if needed but physicians don't want to over-treat and have the unnecessary risk of side effects from chemotherapy treatment if it's not warranted.

The OncotypeDX test usage to guide treatment decisions among women with node-negative, estrogen receptor-positive breast cancer is resulting in good outcomes according to a study reported in the journal Cancer.

The OncotypeDX test evaluates the activity of twenty one genes from a sample of the patients' cancer to determine their Recurrence Score -- the risk of a patient experiencing a recurrence ten years following diagnosis. This test gives a more individualized treatment for women with early stage breast cancer and would allow women who are unlikely to benefit from chemotherapy to avoid the toxic effects of treatment. The Recurrence Score ranges from 0 to 100, with a higher score indicating a greater risk of recurrence.

Using the Recurrence Score guided approach, low-risk women would be treated with Tamoxifen alone, and intermediate and high-risk women would be treated with Tamoxifen and chemotherapy. The study results suggest that among women with early stage, ER positive breast cancer, use of the OncotypeDX test to individualize treatment decisions appears to produce good outcomes at an acceptable cost.

North Carolina State women's basketball coach Kay Yow is still in the game, despite her difficult match-up with a fierce opponent -- breast cancer.

Yow is fighting for the third time a disease that has been spreading throughout her body since last fall. She has sores in her mouth, hasn't been able to eat, and receives regular doses of pain medication, antibiotics, and nutrients to combat the effects of three chemotherapy drugs that are cycling through her tired body.

Still, Yow is never far from the sidelines.

She was right there in the mix the day NC State named its women's basketball court in her honor. Shortly after, she was wheeled off the court on a stretcher, headed for the hospital so she could be pumped full of drugs. She was at work the next day. And at the unveiling of the Kay Yow Court. And at her game that same night. And at the end of the night, with an oncologist and nurse, she was accompanied to her office where she was once again hooked up to an IV so drugs could once again drip into Yow's exhausted body.

Yow, 65, is tough and determined.

"I know people are saying I'm doing too much," Yow says. "I know I have to take care of myself. But it's not like I have a cold or pneumonia and if I rest it will get better. Rest is not going to cure cancer. If rest were just the answer, that's what I would do."

"But if someone can be involved with something that is a passion for them, then I don't think there's anything wrong in trying to do that. Coaching lifts me up. Once the ball is tossed up, I forget pretty much about everything and just focus on the game. If I just do nothing, I feel like I'm giving in to the disease."

For anyone keeping score on the battle between Yow and cancer, it's clear Yow is a winner.

Previous posts about Kay Yow are as follows:
NC State coach takes leave to fight breast cancer
NC State basketball coach Kay Yow back in the game

Oncotype DX is a diagnostic test that quantifies the likelihood of disease recurrence in women with early stage, node negative breast cancer. With the information provided by the test it may be possible for doctors and patients to make more informed decisions about breast cancer treatment options.

Oncotype DX analyzes a specific set of genes within a tumor to determine a recurrence score. The recurrence score is a number between 0 and 100 that corresponds to the likelihood that a recurrence with happen within 10 years of initial diagnosis.

Results presented at the 2006 annual San Antonio Breast Cancer Symposium (SABCS) stated that the Oncotype DX test can more accurately predict estrogen receptor (ER) status than the two other commonly used tests, immunohistochemistry and ligand binding.

Another Oncotype DX study presented at the SABCS said that the test could predict the response to Tamoxifen by the levels of estrogen expression.

The researchers concluded that ER and PR expression, as measured using the Oncotype DX test, provide different pieces of information about prognosis and likely response to Tamoxifen among patients with node-negative breast cancer.

When I first looked at my pathology report more than 18 months ago, it made little sense. Terms like Bloom Richardson Score and margins and Her2Neu were as foreign to me as the breast cancer that somehow invaded my body. So I read it over and over again and was eventually able to identify the basic meaning hidden within the four pages that detailed my disease. As it turned out, this report was my map. It led me in various directions for various treatments. It contained some roadblocks. It was sometimes confusing. And sometimes I got lost. There were some good and not-so-good stops along the way. And in the end, I reached my final destination -- in the land survival. And this is where I hope to stay. For a long time.

My map is not necessary anymore -- although I still look back at it. I've found that it makes more sense now that time has passed. I can interpret it more objectively, with more perspective and less emotion and fear. I am still learning about the disease that was removed from my breast. And I am realizing there was a lot I never really knew -- like these seven subjects -- when breast cancer was new and fresh and debilitating.