Diagnosed with stage 2 breast cancer 13 years ago, Susan Bakken had a lumpectomy and a sentinel node biopsy, which thankfully revealed that the cancer hadn’t spread. Although nothing indicated that Susan required any other treatment, she still wanted to have a genomic test– Oncotype DX Breast Recurrence Score–that would predict her risk for distant cancer recurrence, and whether she’d actually benefit from chemotherapy.
Susan had serendipitously heard about the Oncotype DX test through a friend of a friend who knew someone who worked at Genomic Health, the company that created it! Despite the fact that Susan’s mother–herself a breast cancer survivor– couldn’t fathom why her daughter would have such a test, 59-year-old Susan thought “why wouldn’t I?”
The test results revealed that Susan’s cancer would likely return. “I was at high risk for recurrence, so there was no question that I would go through radiation and chemotherapy, the recommended treatment,” Susan said. “I didn’t want the cancer to spread.”
The Oncotype DX Breast Recurrence Score test determines the level of activity, within a tumor sample, of 21 specific genes — 16 genes linked to breast cancer and five control genes. The measurement of these genes is calculated to yield an individualized result called a Recurrence Score, which correlates with the likelihood that a woman’s breast cancer will return (distant recurrence), and also predicts whether she is likely to benefit from chemotherapy. The higher the Recurrence Score, the greater the chances that breast cancer will return, and the more likely she is to benefit from chemotherapy.
The test has been used to help guide more than 750,000 breast cancer treatment decisions worldwide and has now been shown through prospective clinical studies to accurately predict clinical outcomes in over 63,000 breast cancer patients.
It’s chilling to think that if Susan’s friend hadn’t told her friend about Susan’s cancer diagnosis, Susan probably wouldn’t have heard about the critical test that helped determine the course of her treatment. Were it not for radiation and chemotherapy, Susan might not be celebrating her 13th cancer-free anniversary. In fact, not many doctors knew about the Oncotype DX test when Susan was diagnosed, and even though more know about it today, many women still aren’t informed about it.
70 Is The New 40
Impacting nearly a quarter of a million women annually in the United States, breast cancer is by far the most common form of the disease in women (excluding some types of skin cancer.) Yet, many of us would be shocked to learn that although a majority of cancer patients pursue costly and toxic chemotherapy treatments, only four in 100 patients actually benefit from them! Susan was one of the lucky women. Overtreatment of cancer, including breast cancer, is an important healthcare issue today.
We can be comforted to learn race, education, and socioeconomic status do not influence whether a woman receives genomic testing, according to recent analyses from the National Cancer Institute’s (NCI) Surveillance, Epidemiology, and End Results (SEER) Registry. It’s discomforting, however, that women 70 years old and over who have been diagnosed with breast cancer are over three times less likely to receive genomic testing than younger women. Every single woman, no matter what her age, deserves to know about every single one of her treatment options.
Treatment regimens today can be tailored so that they’re safe and effective for patients at any age. But when only 8.2 percent of women 70 years old and over are getting a genomic test to guide their cancer treatment, outcomes are worsening. Many older women aren’t receiving chemotherapy that would otherwise benefit them, and many are dying of breast cancer. Others are receiving chemotherapy who shouldn’t be. Undertreatment can be just as damaging as overtreatment.
Your Unbiased Resource For Credible Information
“Doctors may tell a 70-year-old patient that she’s too weak to take chemo, so she won’t need to get genomic testing. But 70-year-old patients today are a lot stronger than patients were 20 years ago,” asserted Rita Lusen, a vice-president at Breastcancer.org, which prides itself on its reputation as a credible, unbiased resource for breast cancer info and online support. “All patients have the right to know if they can benefit from chemotherapy,” Rita added.
Each individual breast cancer diagnosis involves many variables which can impact treatment, including a woman’s state of health. “Whether she’s 40 or 80, the question is how well can she physically deal with chemotherapy,” Rita explained. “The collaboration and communication between the oncologist and patient become vitally important.”
Genomic testing is a critical index that helps the patient and the doctor determine if chemo is the right path to take. If a patient has health issues, but her index is low, you don’t want to put her at risk with chemotherapy. It’s another story if her index is high, Rita said.
“Testing guidelines can be confusing. Our role at Breastcancer.org. is to bring medically vetted, valid information to women who can have conversations with their doctors and make the right choices for their treatments,” Rita added. “Every woman needs to take her own path based on her subtype. So much foreign terminology is thrown at her after a diagnosis, and she’s in an unfamiliar world.”
Become Your Own Health Advocate
Partnering with several of the country’s most prominent breast cancer advocacy groups, including Breastcancer.org, Genomic Health has launched the No Matter My Age campaign. The mission of the campaign is to educate and raise awareness about the need for all patients–regardless of their age–to gather as much information as they can before making a treatment decision. And, don’t miss this marvelous two-minute video which powerfully communicates the importance of being your own health advocate, and not letting someone else decide your treatment.
It’s been almost 13 years since Susan Bakken’s anything-but-routine mammogram turned her world upside down. And, she has the Oncotype DX Breast Recurrence Score to thank for putting it right side up. “That’s what carried me through and I’ve been on a positive journey ever since. I’m 71 now, and thankful for every day I have,” she said.