Oncotype DX: Disappointing Results and Discrepancies



Picture me looking something like this
as you read this blog.
Grrrr.

 
Last Friday I received a disappointing call from Kristen, Dr. Cross's nurse.  It was concerning my score on the Oncotype DX lab test.  Anything over 30 means I have a high possibility for recurrence.  I got a 54.  Ouch.

So this week my visit with my oncologist, Dr. Beck, took a serious turn (not that things haven't been serious - I'm getting tired of all this seriousness).  With my disappointing results from Rational Therapeutics in hand and the knowledge of that high Oncotype score, I sat before him and waited to hear the game plan.  I had tons of questions concerning the discrepancies I saw on the chemo recommendations from Rational Therapeutics, many of which he, too, did not understand or necessarily agree with. 

Then he informed me that, according to the newest pathology report from the Oncotype testing, the hormone receptivity on my tumor had CHANGED!  What the...??  Changed?  Seriously?!  

The report from the Oncotype report showed it to be ER/PR negative, as opposed to the original biopsy that showed my tumor to be ER/PR positive.  My tumor had changed!  How is that possible? 

His hypothesis on this whole conundrum was that the original needle core biopsy only showed a small section of the tumor, which apparently had positive hormone receptivity, while other sections may have been growing differently.  Then the chemo regimen I was on, which was specifically for ER/PR positive breast cancer, possibly did kill those cells, which, in turn, allowed the ER/PR negative cells to grow...at least that's the way I understand his explanation (or more like his guess). 

Of course, I queried Dr. Google about this.  He has been less helpful than normal.  In fact, it seems he knows nothing.  This is beyond frustrating and not a little bit irritating. 

A part of me wonders if someone screwed up the original pathology report.  Several weeks ago, when I realized my tumor was growing as opposed to shrinking, I actually asked Dr. Cross if that was a possibility and he promised me it was not.  And to be truthful, I remember that first 10 days or so after I started chemo thinking that my tumor felt smaller and I know it quit hurting for a while, so maybe Dr. Beck's hypothesis is correct.

Whatever the case, once again I have been told how strange this all is.  Dr. Beck now says he has NEVER had a case like mine.  That is not something to be proud of.  That's what you do NOT want to hear from your oncologist...ever. 

I asked him about going to MD Anderson and he was all for it.  He said that's what he would do and that, even though I am a strange case, he seemed to think I wouldn't be quite so strange down there.  So it looks like, at some point in the near future, David and I will be driving to Houston for several days.  MDA called me yesterday to set up everything.  I was hoping to head out asap, but their first available appointment is December 13.  They are trying to find an earlier date, so we are praying for that.  I return to school in January and would really like to get this trip behind me and get a couple of rounds of chemo under my belt...before I'm back in school.  And before more cancer has the chance to start growing.