ONCOTYPE DX

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Patient Stories

Susan B.

In 2004, at the age of 59, Susan, a high-school art teacher who had been married for 39 years, with three children and six grandsons, had a routine mammogram revealing an irregularity that turned out to be infiltrating ductal carcinoma.

Following a lumpectomy to remove the tumor and a sentinel lymph node biopsy, Susan underwent a series of tests, including a PET/CT scan to determine if the cancer had spread. She was reassured when all of these tests were negative, but Susan wanted to have more confidence that her cancer was not likely to recur. After hearing about Oncotype DX^® from a friend, Susan asked her doctor about it.

Her physician agreed she would be an appropriate candidate, since her tumor was classified as lymph node-negative estrogen-receptor-positive, and this information could help them evaluate her subsequent treatment options.

To Susan's and her physician's surprise, her Oncotype DX Recurrence Score^® result was 31, indicating that she was at high risk of her breast cancer returning and would be expected to benefit significantly from chemotherapy.

"I looked at the doctor like he had the wrong person," recalled Susan. "I was just cruising along with all of these negative tests and thought I'd be done with it all by the end of the summer."

Based on her high Oncotype DX results and other factors, Susan's physician recommended chemotherapy, which she began immediately.

"Even though I didn't want to do the chemo, I knew it would lessen the chances of cancer recurring. And based on all of the other tests I had after the lumpectomy, my doctor said he wouldn't have recommended otherwise," explained Susan.

Diane S.

A commercial airline pilot with 27 years of experience, 50-year-old Diane is no stranger to making difficult decisions. Yet in December 2005, when she discovered a small lump in her left breast during a self-examination, she found herself on a critical quest for assistance and answers.

An inconclusive mammogram led to an ultrasound, which revealed small areas of concern. A tissue biopsy confirmed her worst fears. Rather than one sizable tumor, Diane's cancer took the form of many tiny tumors scattered within a 2 ½-inch area of her breast. She was immediately treated with a mastectomy and breast reconstruction in mid-January 2006.

More tough questions followed. Although the tumors themselves were very small, the affected site was quite large, so Diane's physician could not confidently rule out the need for chemotherapy based on standard measures such as tumor size and grade. Diane worried about her future health and job security. "Because I am petite, there was concern that I would be less able to withstand the serious side effects of chemotherapy," said Diane. "In addition, airlines vigilantly monitor the health of their pilots, and a diagnosis of cancer can mean a permanent suspension from flying."

In his search for information, Diane's physician turned to Oncotype DX for a genomic analysis of her disease. About a week later, Diane learned that her Recurrence Score result was 13, suggesting that she has a lower risk of recurrence. In discussions with her physician, she felt more confident that she could avoid the chemotherapy and its side effects without increasing the likelihood of recurrence, and she was able to continue her career and active lifestyle. Also, she was able to keep her long hair, which she's spent 23 years growing.

"Thirteen is my lucky number now," Diane stated.

Katherine Y.

In 2003, Katherine, a 53-year-old podiatrist and one of the first female karate black belts in the United States, found a lump in her breast during a self-examination. After multiple rounds of tests and a double mastectomy to remove her invasive breast cancer, Katherine had to choose whether to get chemotherapy to reduce the likelihood of her cancer recurring.

As Katherine contemplated her decision, her husband learned about Oncotype DX, a new test that was coming onto the market. Katherine's physician had heard about the test but didn't think that it would be available for a couple of years. They made a deal that if she did the legwork in researching when the test would become available, and he determined that it was appropriate for her management, he would order it for her. In the meantime, standard assessments of Katherine's tumor indicated that chemotherapy would be necessary. She called Genomic Health regularly to see if the test was available.

In January 2004, Katherine became the first woman to use the Oncotype DX breast cancer test and learned she had a Recurrence Score result of 18.

Following treatment with an aromatase inhibitor, Katherine has become a certified ski instructor along with her husband. They enjoy spending time together with their dog, Connor, who is also a cancer survivor.

Sandy P.

For Sandy, a 38-year-old preschool teacher and young mother, the thought of breast cancer never crossed her mind; she did not do regular breast self-examinations. However, during Memorial Day weekend in 2006, she made an unexpected and alarming discovery—a lump the size of a small marble in her left breast.

Confirmed by mammography and ultrasound, the lump was revealed to be malignant by a needle biopsy procedure. Less than one month after her initial discovery, Sandy underwent a lumpectomy to remove the tumor and also removal of 11 lymph nodes, all of which turned out to be negative for cancer.

Sandy then faced the challenging decision of whether or not to have chemotherapy. She knew patients with tumors the size of hers—slightly over one centimeter—were on the borderline in terms of being recommended for chemotherapy treatment. Guided by her physician, she turned to the Oncotype DX test for greater insight about her tumor so that she could make an informed decision about beginning a therapy associated with potentially debilitating side effects.

When her Oncotype DX Recurrence Score came in at 28, at the high end of the intermediate-risk range, Sandy immediately decided to proceed with a two-month course of chemotherapy. Although she experienced bouts of fatigue, she found the side effects to be surprisingly manageable. In fact, with help and support from her husband and two young sons, she continued her job teaching a lively group of four-year-olds. A competitive swimmer in high school, she also kept up an active exercise program, swimming three times a week.

"The additional information provided by Oncotype DX made a difficult decision much easier." said Sandy. "It was as if I was standing at a huge fork in the road and Oncotype DX helped me decide which path to follow. Once I began treatment, there was no second-guessing. I felt as if I had made the best possible decision for me, and I was able to concentrate all my energies on getting better."

Penny S.

In June 2004, at the age of 55, Penny had a mammogram that raised some questions about her right breast. Additional mammograms, including some with magnification, were inconclusive, so Penny went on with her life, enjoying retirement after working as an information systems analyst.

Then in December, during her annual gynecological exam, Penny's doctor found a lump in her right breast. A subsequent mammogram, ultrasound and biopsy confirmed Penny had breast cancer.

"When I got the call from the surgeon, my husband and I both lost it. I thought I was dying. I felt like I had no control."

In March 2005, Penny underwent a double mastectomy, and the surgery revealed she had lobular breast carcinoma, which fortunately had not spread to her lymph nodes.

Penny had more treatment decisions to make but struggled to understand exactly what type of breast cancer she had. Fortunately, a friend from Penny's Bible study group worked for Genomic Health, and he explained that because her tumor was classified as lymph-node-negative, estrogen-receptor positive, she could use a test called Oncotype DX to determine the likelihood that her cancer would return.

Penny's doctor ordered the test. Her Recurrence Score result was 13, indicating that there was a low risk that her breast cancer would return. Penny and her doctor decided that she would forego chemotherapy and opted for radiation and hormonal therapy only. Penny credits the test with putting her back in control of her disease and life.

Today, Penny is healthy and busier than ever growing and selling produce at the farmers' market, making wine with her husband and looking after over 70 animals that live on their land.

Laurie L.

Laurie, a published non-fiction author and Harvard-trained anthropologist, was no stranger to cancer, having survived Stage IIIB non-Hodgkin's lymphoma in 1977 at the age of 27. Back then, Laurie was treated with radiation and a lengthy course of chemotherapy.

However, that did little to ease the shock when an annual mammogram came back abnormal in November 2005. "In my gut, I knew it was cancer again," Laurie, now 58, said. A biopsy confirmed her suspicions.

Laurie already had an oncologist she trusted, and he enlisted a surgeon and radiologist. Because Laurie had previously undergone radiation therapy, her medical team was unsure if a lumpectomy was a viable option. Fortunately, the team tracked down medical records from three decades prior and was able to administer radiation therapy in such a way that Laurie was able to have a lumpectomy rather than a mastectomy. Because her margins were not clear after the first surgery, Laurie underwent two surgeries.

She began hormonal therapy right away but wanted to avoid chemotherapy because she had previously received chemotherapy for her lymphoma. "Given my history, going through chemo again would have been terribly risky," Laurie said.

Her oncologist recommended using the Oncotype DX assay to determine the likely benefit Laurie would obtain from chemotherapy. She was relieved when her Recurrence Score result of 17 indicated that she had a relatively low risk of her cancer returning. With these results, Laurie, in close consultation with her oncologist, opted to forgo chemotherapy. "There are so few resources that can give you that degree of guidance, direction and information to make your treatment decisions," Laurie said. "I felt like science was really taking care of me."

Laurie has completed radiation therapy and is in a five-year course of hormonal therapy. An avid hiker, long-distance swimmer and tai-chi practitioner, she remains very physically active.

Catherine S.

Catherine ("Cat"), a registered nurse and pharmaceutical sales representative, found a lump in her breast while taking a shower in April 2006. She contacted her family physician the next day and had a mammogram and ultrasound. After a core biopsy, her physician told Cat, now 56, that she had breast cancer.

To learn about breast cancer and her treatment options, Cat began doing research online. She found BreastCancer.org, a very informative website, and learned a lot from its chat room and message board. After Cat posted her biopsy results online, a cancer survivor named Pat recommended that she look into the Oncotype DX test, because she was a candidate for it, and pointed Cat to Oncotype DX.com.

Cat mentioned the test to her oncologist but found her reluctant to order the test. She had ordered it for a few patients, but because all their results fell in the intermediate-risk range, she was unsure of the test's value. She also argued that insurance might not pay for the test. Cat still thought that Oncotype DX could be helpful and was willing to pay for it, so her oncologist ordered the test.

Before she received the result, Cat went in for her lumpectomy. Anticipating that Cat would need chemotherapy, the surgeon wanted to put in an implantable port at the same time. But Cat refused, reasoning that she wanted to be more confident she would be likely to benefit from chemotherapy before having a port implanted.

When Cat received her Recurrence Score result, it was a 0, suggesting a low risk of distant recurrence assuming 5 years of tamoxifen therapy. "I didn't know you could even get a 0!" she said. "I was thrilled!" She and her oncologist agreed that she would not be likely to benefit from chemotherapy. In addition, her insurance company completely covered the cost of the test.

Following her lumpectomy, Cat had radiation treatment. She is on hormonal therapy and is continuing to do well. In the summer of 2007, she drove from her home state of Florida to North Carolina, to meet and spend a weekend with Pat, who had told her about Oncotype DX. "It was an emotional meeting," Cat said. "Both Pat and her daughter have had breast cancer. She had been through so much herself, but was so helpful to me. We were strangers when we ‘met' online, but we've really bonded over the course of my journey through treatment."

Susie R.

Susie, a retired nurse, found a dimple in her breast during a self-exam in February 2007. Although a mammogram and an ultrasound showed no evidence of an abnormality, a surgeon with whom she had previously worked insisted that she come in for an exam. He was concerned with what he found.

A biopsy revealed that Susie, age 55, had breast cancer. The following week, she had a lumpectomy and a sentinel node biopsy. She had Stage I, node-negative cancer. Susie's oncologist, surgeon and radiation oncologist agreed that she would need radiation therapy but could forgo chemotherapy. However, Susie, a former oncology nurse, was concerned that her cancer might be more likely to recur without chemotherapy.

Her oncologist ordered the Oncotype DX test. Susie's Recurrence Score result was 16, indicating that her recurrence risk was in a low risk group. The test indicated that she was in a group that was not likely to benefit from chemotherapy, and her oncologist planned to treat Susie with radiation and tamoxifen.

"The Oncotype DX assay sealed the deal," Susie said. "Knowing I could make a game plan with some certainty helped me get back to normalcy."

Susie completed her radiation therapy in the summer of 2007 and continues to take tamoxifen. Now 56, Susie is busy helping raise two of her young grandchildren. She is also active in a garden club and enjoys skiing with her family.

Elizabeth S.

In September 2005, Elizabeth, a jewelry designer and full-time mom, noticed a lump in her breast and thought it was probably a fibroid. When she went for a routine mammogram that month, Elizabeth told the technicians about the lump, but it did not appear on the films. A sonogram showed the lump as a solid mass. Elizabeth immediately underwent a biopsy, which revealed a 1.9-centimeter tumor.

Fortunately, the tumor was lymph node-negative (N-) and estrogen-receptor-positive (ER+), which meant it was contained—all positive for Elizabeth's prognosis.

She underwent a lumpectomy, followed by radiation treatment. Her tumor was close to the breastbone, so to be safe, her surgeon removed 23 lymph nodes along with the tumor.

Next, Elizabeth began to search for an oncologist, visiting two oncologists who had come highly recommended. Given her status as pre-menopausal and the size of her ER+ N- tumor, both of them recommended chemotherapy followed by hormonal therapy—the standard treatment for this type of cancer.

"This was heartbreaking to me, to be hit with this at 40 years old with two young boys. I still wanted a third child," said Elizabeth, now 42.

Elizabeth's mother had been diagnosed with non-invasive breast cancer at age 64 and was treated with a lumpectomy and radiation. Elizabeth had hoped that her treatment would be similar. After her diagnosis, Elizabeth researched doctors, treatment and support systems to find what would work for her. "It was like a full-time job," she said.

One morning, Elizabeth's brother called to tell her about Oncotype DX testing, which he'd seen on a TV report. Elizabeth asked her surgeon about the test, and he determined that she was a candidate for the test and ordered it for her. None of the oncologists she had been to had told her about the test. "I found out about it from my brother, an investment manager at an investment bank—not the medical professionals I'd spent so much time seeking out," she said.

Elizabeth's Recurrence Score result was 16, indicating that her recurrence risk was in a lower range. Elizabeth made an appointment with an oncologist at a cancer center in New York to discuss her result. After the previous oncologists' recommendations of chemotherapy and hormone therapy, Elizabeth was surprised to hear her new oncologist say that she didn't think chemotherapy was necessary and was confident treating her with hormone therapy alone. Elizabeth's Recurrence Score suggested that chemotherapy would provide minimal benefit.

Today, Elizabeth has completed radiation therapy and is continuing hormonal therapy. She is confident in her decision not to undergo chemotherapy, based on her Recurrence Score results. "What a great thing to be differentiated within this class of women with breast cancer," she said. "Not all cancers are the same, so why treat everyone the same way with something so toxic? It's so remarkable that finally, you can distinguish one person's cancer from another—I'm just so thankful."

Joyce H.

When Joyce had a routine mammogram in 2006, everything seemed fine. Then the chief of radiology at her local hospital called her in for additional imaging. She was called back a second time for a surgical biopsy, which revealed that Joyce, at age 63, had breast cancer.

Although Joyce had been diagnosed at a smaller medical practice in the Boston area, her son-in-law, a California-based surgeon, advised her to take advantage of the resources available at the major teaching hospitals in Boston and referred her to a surgeon at one of the hospitals there for treatment.

A lumpectomy and removal of a sentinel lymph node revealed that Joyce had node-negative infiltrating ductal carcinoma.

After surgery, Joyce met with her oncologist to discuss the next step in her treatment. Her oncologist recommended radiation therapy and said that chemotherapy might also be needed. Joyce began researching breast cancer treatment and found that chemotherapy can affect the heart, bones and brain, as well as cause nausea and hair loss. "I really didn't want to have it," she said. "Given my age and the type of cancer I had, it didn't seem likely that I would benefit much from chemo."

She asked her oncologist if there was a test that could tell her whether chemotherapy would likely be beneficial, and her oncologist recommended—and ordered—the Oncotype DX test. Joyce's Recurrence Score result was a 24, indicating that she was at an intermediate risk for cancer recurrence. In patients with a Recurrence Score in the intermediate range, the benefit from chemotherapy is still being studied to determine how likely these patients are to respond to this treatment.

Joyce and her oncologist decided against chemotherapy. "My Recurrence Score result was one more piece of information that helped us make that decision," she said. "You want to get as many facts together as you can." Joyce had radiation therapy and is taking tamoxifen.

Now 65, Joyce is back to her normal life. She stays busy taking care of her young grandson. A former art teacher, she also works on prints and watercolors in her home studio. She stays active by participating in Jazzercise, and she and her husband enjoy traveling.

Suzie W.

When Suzie had a routine mammogram in September 2007, it revealed clustering of micro-calcifications in her breast. After a sonogram and wire localization biopsy, she was diagnosed with both invasive and non-invasive breast cancer.

Suzie, then 63, was floored. A retired university economics professor and administrator, as well as a devotee of rigorous daily exercise, she had never been sick or missed a day of school or work. Knowing that she and her husband were about to leave on a month-long trip abroad, her surgeon started Suzie on hormone therapy before she left.

When she returned, Suzie met with her surgeon to plan her next step. The invasive cancer had been removed during the wire localization biopsy. To remove the non-invasive cancer, Suzie and her surgeon decided on a mastectomy and removal of the sentinel lymph nodes. This way, she was able to avoid radiation and its potential side effects.

After the mastectomy, her surgeon told Suzie that she seemed to be a good candidate for the Oncotype DX test, which could help guide her chemotherapy decision and which could be performed on the original biopsy specimen of her invasive cancer. Suzie researched the test online and was determined to ask her oncologist about it.

When she met her oncologist several days later, Suzie was pleasantly surprised to learn that her oncologist had already ordered the test after carefully reviewing her file. More good news soon followed: Within a few days, Genomic Health called Suzie to inform her that her insurance would cover the full cost of the test.

Less than a week later, Suzie received the best news of all. Her oncologist called to tell her that her Recurrence Score result was an 8, meaning that chemotherapy would likely be of little benefit, so her oncologist recommended against it. "I was elated," Suzie said.

Suzie will be taking hormone therapy for at least 5 years. "I have hot flashes and night sweats from the hormone therapy," Suzie said. "My friends and family laugh when I pull my sweater off in the middle of dinner, but I am able to do everything I did before." In fact, Suzie and her husband spend a good deal of time sailing and take their boat to the Bahamas every other year. She also enjoys scuba diving, walking, running and cycling.

"The Oncotype DX assay was a gift to me," she said. "Oh, I think daily about having cancer, but my test results give me great peace of mind regarding the possibility of recurrence."

Deborah W.

In April 2007, Deborah had a mammogram after skipping a few years. Additional mammograms and an ultrasound suggested that she might have breast cancer. A core needle biopsy revealed that she had ductal carcinoma in situ.

Deborah, then 53, met with a surgeon who ordered an MRI of her other breast to make sure there was no cancer there. She also did a separate biopsy to check for lymph node involvement and found none. Her surgeon informed Deborah that a mastectomy was her only surgical option, and that it should "cure" her cancer.

After her mastectomy, pathology results showed that the cancer had broken out of Deborah's milk ducts and had turned into invasive ductal carcinoma. At this point, her surgeon said that Deborah would likely need to be on a five-year hormonal therapy and might also need radiation.

A panel of radiation oncologists recommended against radiation; they thought it might do more harm than good, because any cancer cells left after the mastectomy would be very close to Deborah's chest wall, over her heart.

Deborah's next step was to see an oncologist, who prescribed a five-year course of treatment with an "aromatase inhibitor"(a type of hormonal therapy). Realizing that she would need to see an oncologist often, Deborah found one closer to her home.

During their first appointment, the first thing the new oncologist asked Deborah was, "What are the results from your Oncotype DX assay?" Deborah hadn't heard of the test, so her oncologist explained that it can help doctors assess whether women with certain types of breast cancer are likely to benefit from chemotherapy.

Deborah worked with her surgeon's office to order the test. Her Recurrence Score result was a 33, meaning she had about a 22% chance of recurrence (on average, with a range of 17% to 27%). Her oncologist immediately began chemotherapy, telling Deborah that she should have started it weeks before.

"Looking back at my treatment decisions, it was a real rollercoaster," Deborah said. "I kept hearing I was going to be cured, which made me confident that I would be, but it turned out I was at a high risk of recurrence. The Oncotype DX assay and my Recurrence Score result really helped change everything."

Now 54, Deborah has completed chemotherapy and continues to take an aromatase inhibitor. To keep her strength up, she began working with a personal trainer soon after she was diagnosed and continues to train today. A professional painter of murals and decorative finishes before her diagnosis, Deborah now focuses on pet portraits. And speaking of pets, both Deborah and her husband Randy stay busy with their two standard poodles.

Linda P.

"Of all the things that could ever happen to me in my life, I never thought I would get cancer," Linda said. Still, that was her sudden reality when she was diagnosed in June 2006. "There was a shock factor there." Speaking of her initial experience and the rapid journey from diagnosis, to an MRI, to surgery, Linda called it, "a long, terrible weekend."

Linda had a mammogram exactly one year before her diagnosis that showed nothing. Then, the next one showed a 2.2 cm tumor. She saw a surgeon and had a biopsy, then received a phone call telling her it was malignant. Within a week or so, Linda had a right breast lumpectomy, and her doctors instructed her to have radiation and tamoxifen therapy.

"I was against having chemotherapy," Linda said. "My oncologist told me about a clinical trial involving the Oncotype DX assay. Although I didn't participate in the trial, I did want to have the test, and Genomic Health was invaluable in helping me get reimbursed for it. We sent off the tumor and two weeks later, I had my result—my score was 28, meaning I was at medium to high risk for cancer recurrence."

"Oncotype DX affected my treatment decision totally," Linda said. She noted that her surgeon and oncologist recommended chemo. Although she had been completely against it, she decided to undergo chemo because the test results indicated that she was at medium to high risk for recurrence. Linda said that she was more confident in her decision. A week after that meeting, Linda started chemotherapy.

"I shaved my hair; my attitude was, 'cancer isn't getting it.' It had been brown. When it came back, it was silver," said Linda. "I teach third-grade religious education. I subbed one day while I had a bald head. I wore a scarf. All the kids wanted to see my bald head. A few months later, some of the same kids saw me again and said, 'Mrs. Porter, you have hair!'"

It took Linda almost a full year to get her strength back. "I'm back to working full time, as a human resources manager for an engineering firm, and doing volunteer work," said Linda. "I love entertaining and cooking. Every four months, I see my surgeon, radiologist or oncologist, then my gynecologist and family practice doctor." Linda's cancer was detected following a regular mammogram. Linda said, "be faithful to your mammograms!"

Deborah C.

When Deborah was diagnosed with breast cancer in September 2007, the news was unwelcome but not unexpected.

Deborah, 44, had been having mammograms since she was 30. Her breasts had fibrocystic tissue, along with extensive calcification, which resulted in lump-like calcium deposits. After one of those lumps grew in size over a span of 7 months, she had a lumpectomy and a biopsy, which led to a diagnosis of breast cancer.

Her pathology report showed that the margins were not clear, so Deborah and her surgeon had to decide between additional surgery to clear the margins followed by radiation versus a mastectomy. Because she wanted to minimize the chances of local recurrence, and because there was a high risk that her other breast might also develop cancer, Deborah wanted to have a double mastectomy, and her surgeon agreed.

After surgery, Deborah did research online to help evaluate whether chemotherapy would be beneficial for her. A brief mention of the Oncotype DX test drove Deborah to research it further, and she and her oncologist agreed that she was an appropriate candidate for the test.

Deborah's Recurrence Score result was 14, indicating that her risk of recurrence was low and that she would likely derive little benefit from chemotherapy, which came as a relief. She said she was pleased to find out that there was a test that could help her evaluate how beneficial chemotherapy might be for her. "I was already resisting the idea of having chemo, both because it seemed unlikely to be of much benefit, and because it would have undesired and negative side effects," she said. She explained that her Recurrence Score result supported her decision, in consultation with her physician, not to have chemo.

Deborah remains busy with her animal rehabilitation practice, working with cats and dogs that have orthopedic and neurological problems. In fact, when she was diagnosed with breast cancer, her first thought was for her patients. "I realized treatment was going to take a lot of time out of my schedule, which may sound strange. But I have a duty and responsibility to my animal patients, and I needed to balance that against my treatment."

Always an avid athlete, Deborah continues to jog, cycle, weight train and swim.

Gail B.

When Gail, a retired medical assistant, was diagnosed with hormone-receptor-positive, lymph node-negative breast cancer last December, she was upset by the diagnosis but not very surprised since many of her friends and family have also faced breast cancer.

At first Gail only wanted to take radiation and hormonal therapy because her tumor was small, but her doctor urged her to consider adding chemotherapy to her treatment plan. Because Gail wasn't certain about the best treatment for her breast cancer, her doctor recommended that she take the Oncotype DX test. This test looks at the activity of 21 genes within a woman's breast tumor to better understand how her individual cancer is behaving.

When Gail learned about the test, she remembers that, "I wanted to do it because I knew it would help me make a treatment plan with my doctor." The Oncotype DX test measures an individual woman's chances of benefiting from chemotherapy, as well as the likelihood that her cancer will return or spread in the future. Having this information was important to Gail, since she knew that not all women will benefit from chemotherapy.

Gail's test results were in the intermediate range, indicating that her cancer was somewhat more likely to return in the future than the cancers of women in the low-risk group. Gail recalls that, "I had made up my mind not to take the chemo, but I also wanted to do everything I could to try and prevent the cancer from returning. So when I saw the results, I knew what I needed to do and felt more confident about my decision to add chemotherapy to my hormonal treatment."

Today, Gail has completed both her chemotherapy and her radiation treatment. She continues to take her daily hormonal treatment and will do so for five years. She is back to feeling good and enjoys spending time with her new husband, Alphonse, and caring for her mother. In her spare time, Gail loves window-shopping and follows all the fashion trends—she even had her wig cut to look just like Rihanna!

Vilma M.

When Vilma had a routine screening mammogram in August of 2007, it revealed an abnormality. During the following two weeks, she had a diagnostic mammogram, an ultrasound, and a biopsy. With her diagnosis confirmed, Vilma, 48, knew she was facing surgery.

Vilma met with a general surgeon who recommended a lumpectomy, the most conservative procedure. During the surgery, he also removed a sentinel node, which was positive. This prompted a second surgery; an axillary node dissection. An additional 13 nodes were removed, all negative. The surgeon informed her that the positive sentinel node was a sign that her cancer had spread to the axilla and that her treatment plan should include chemotherapy. He referred her to an oncologist.

Before further treatment, however, Vilma needed to recover from her surgeries. She used this time to learn more about breast cancer treatment. She found Dr. Susan Love's Breast Book and www.komen.org especially informative. From Dr. Love's book, Vilma learned about the Oncotype DX^®, which is a relatively new test, and planned to ask her oncologist about it.

During her initial consultation, her oncologist mentioned Oncotype DX testing. "I was excited that she recommended the test," Vilma said. "It showed that she was familiar with current breast cancer practices and wanted to form a comprehensive treatment plan. I felt confident that I had found the right oncologist."

Vilma's oncologist ordered the Oncotype DX test, and her Recurrence Score^® result was 19, at the bottom of the intermediate-risk range of scores. Her oncologist adjusted her treatment plan on the basis of the Recurrence Score^® result, recommending chemotherapy treatment. Chemo was followed by radiation therapy. And because she was ER+ and PR+, she will be on hormonal therapy for five years.

"The Oncotype DX test gave me a tangible way to view the benefits of chemotherapy" Vilma stated. Now 49, Vilma is enjoying life with her husband and two children.  She continues working as a speech-language pathologist, helping children in public schools improve their communication skills.

Angela Y.

In mid-November 2006, Angela had her annual mammogram. The results showed that there was some calcification in her breast tissue, which can be a sign of cancer. After a second mammogram and a fine-needle biopsy, Angela was diagnosed with breast cancer. She was 42 at the time.

"Before that initial mammogram, I had no reason to suspect that I had breast cancer," Angela said. "I had none of the usual risk factors, and there's no history of breast cancer in my family."

Angela saw a surgeon right after she was diagnosed. Because Angela is small-breasted, her surgeon recommended a mastectomy, which offered more potential for reconstruction than a lumpectomy. She had the mastectomy about a week after meeting with the surgeon.

After a few weeks of recovery, Angela saw her oncologist. He recommended hormonal therapy (tamoxifen) and chemotherapy, but left the chemotherapy decision to her. Angela asked if there were any other treatment options, but found that there weren't many for pre-menopausal women with pathology results like hers.

Her oncologist used Adjuvant! Online to gauge how likely Angela's cancer was to return if she proceeded with both tamoxifen and chemotherapy. The combined therapy could decrease her likelihood of recurrence by 5%, and increase survival by 1%. Based on these results Angela didn't think this information was definitive enough to make a decision.

Beginning in January 2007, focusing on the long-term effects of chemo, Angela began to do her own research. After pouring over various studies, she discovered that some of the potential chemo side effects, such as memory loss and heart damage, may occur. She also read that the immune system can be weakened significantly. With this info in mind, she worried that the side effects of chemo would diminish her ability to care for her large family, and as a mother of four and a caregiver to her parents, she had many depending on her.

At the time of her diagnosis, Angela had a gut feeling that chemotherapy wasn't right for her so she turned to God and friends for additional advice. One of Angela's friends, an oncologist, suggested that she use the Oncotype DX® test, which the oncologist treating her had also mentioned. Her Recurrence Score® result was a 22, which put her in the intermediate-risk range. Although Angela was relieved that her result wasn't higher, she had hoped for a lower score that would more clearly show that she was unlikely to benefit from chemotherapy. Ultimately, Angela decided against chemotherapy.

"It was reassuring to know that the Recurrence Score result was based specifically on my tumor sample, unlike the Adjuvant! Online results, which are based on statistical outcomes from a large number of breast cancer patients," she said.

In February 2007, Angela began tamoxifen therapy. She also enrolled in a clinical trial investigating the use of exemestane in pre-menopausal women. She was randomized to the control group of women taking tamoxifen.

"Some of my friends have recently been diagnosed with breast cancer, and they're pre-menopausal, like me," she said. Angela also has three daughters, so she is eager to support research that could benefit future generations.

Now 44, Angela is doing well. Always fit and energetic, she has taken part in two triathlons, and has remained an active member of her local Church. Today, she stresses the importance that faith played throughout her life – especially since her diagnosis. "Cancer has helped me to not take things for granted," she said. "I want to inspire people to do the things they always wanted to do, but never thought they would. You never know what tomorrow holds, so do it today."

Nancy G.

In April 2006, Nancy noticed that her right nipple was starting to pull in on one side. Because she worked for a local cancer organization, she knew that could be a sign of cancer, but thought it might also be due to her age; she was 55 at the time. Then, she started feeling a lump behind the nipple. In June, she saw her OB/GYN for a clinical breast exam, and had a diagnostic mammogram, as well as a core biopsy. The results showed that all the tissue samples were cancerous.

As soon as she received her biopsy results, Nancy e-mailed a breast surgeon on the board of directors of the cancer agency where she worked. He saw her in his office that afternoon. "I had barely processed my diagnosis, and I was already on the fast track to treatment," Nancy said.

In July 2006, Nancy had a mastectomy and reconstructive surgery. Her oncologist informed Nancy about the TAILORx clinical trial and about the Oncotype DX® Breast Cancer Assay. Nancy decided to enroll in the trial. Her Recurrence Score® result was an 18 — within the range that patients enrolled in TAILORx are randomized to receive either chemotherapy plus hormone therapy or hormone therapy alone.

She was selected to receive chemotherapy as part of the TAILORx trial. She received four chemotherapy treatments and is taking a five-year course of hormone therapy. Although her cancer has not recurred, the hormone therapy is affecting Nancy's bones; her bone density is decreasing, and she has more joint pain.

Now 58, Nancy said "the Oncotype DX test gave me the information to come to terms with undergoing chemotherapy and be at peace with my decision. I was more scared of chemo than the mastectomy, but with the results of the Oncotype DX test, it was easier to decide what I needed to do." Although she understands that some people might see participating in a clinical trial as being a guinea pig, it has been an absolutely great experience for her. "I'm so glad to participate in these trials, not only for my own benefit, but also to provide information that can help other women in the future. I would strongly encourage other women to look into clinical trials as well as take advantage of the Oncotype DX test" she said.

A longtime pet lover with five cats, Nancy now works for her local Humane Society. She stays busy with her family, volunteer activities, and has participated in a second clinical trial.

Jan F.

Jan's personal credo has always been "Be Your Own Advocate." This motto saw her through the years, to her current position as Senior Vice President, Director of Communications at a major bank. It was what fueled her strength and resolve when she was diagnosed with breast cancer.

Conscientious about her health, Jan has never missed an annual mammogram since her first one 20 years ago. She doesn't have a history of cancer in her family. In 2007, after working out with a personal trainer, she felt something unusual on her breast. She immediately rescheduled her mammogram for an earlier appointment.

The mammogram and an ultrasound did not suggest cancer as an explanation for what she felt. But she was relentless, needing complete peace of mind about her condition. After a needle biopsy confirmed the diagnosis of breast cancer, Jan met with a surgeon who helped her decide to proceed with breast conservation therapy and radiation. Her surgeon also discussed Oncotype DX® testing with Jan. This was the first time that Jan had heard of the test. Jan has always been an evidence-driven person, and the way she lives her life didn't change when she was faced with cancer.

Jan says, "I wanted cutting edge options. The more we have in order to make an informed decision, the better. You want to get the best treatment that you possibly can to eradicate (the cancer), and Oncotype DX provides us with an indicator of what that best treatment will be."

Given that she was node negative and had a Recurrence Score of 9, Jan's oncologist discussed with her that chemotherapy offered minimal benefit in her case. Jan followed her oncologist's recommendation to undergo hormonal therapy.

"I have peace of mind that I have a low Recurrence Score. And if it had been a high Recurrence Score, then I might have changed my mind about further treatment," she says. Jan appreciated the way that Oncotype DX allows each physician to treat each woman's situation individually, to help make personalized decisions. She emphasizes how personal the treatment decision is and how important it is to have all the information to make that decision on your own.

"A test like Oncotype DX helps us have those facts that we need to make that decision. You have to make that decision based on what works best for you in your life," she says.

Two years after her diagnosis and cancer-free, Jan stands behind her surgeon's choice to do the Oncotype DX test. Her low Recurrence Score gave her the confidence to choose a treatment path that would allow her to avoid chemotherapy. She is planning a trip to Bhutan later in the year. She especially enjoys spending time with her granddaughter, who is almost 3 years old.

And she continues to champion her motto, "Be Your Own Advocate." She says, "I don't have sleepless nights over breast cancer because I made the best decision I could have made."

Lynda N.

When she was diagnosed with breast cancer in October 2007, Lynda was devastated. After an abnormal mammogram, a biopsy confirmed that Lynda had invasive ductal carcinoma of the left breast. She also had a family history of breast cancer; her grandmother had been diagnosed at age 70. Amidst a whirlwind of emotions, Lynda chose to proceed with mastectomy. Even though the final pathology revealed that she had early stage cancer and was node negative, Lynda believed that she should proceed with chemotherapy.

"The word ‘invasive' made me apprehensive about not doing everything I could do to fight it," she says.

Lynda enjoys spending time with her children and grandchildren. Her weekends are packed with family activities, including fishing, trips to the casino and motorcycle rides with her husband, who is a member of a Harley-Davidson® riding club. Even before discussing treatment options with her oncologist, Lynda was ready to accept chemotherapy as a possibility. "I didn't want to wake up each day wondering if my cancer was going to recur that day. I wanted to be in the game."

But after meeting with her oncologist, who told her about the Oncotype DX® test, Lynda opted to learn precisely what her chance of recurrence was. When her Recurrence Score® value turned out to be 5, Lynda's oncologist explained that chemotherapy would have minimal benefit in her case and recommended hormonal therapy. Today, Lynda continues her treatment with hormonal therapy and is doing well. Looking back on her decision, Lynda is so relieved that she was able to go on with her life without the interruptions of chemotherapy. "I had confidence in Genomic Health® and trust in my physician. I had been given this gift," she says. "I realized that I should go ahead and take it."

With Oncotype DX testing helping her to make a more informed decision about treatment, Lynda felt empowered.

"When you hear that you have cancer, you feel out of control," she says. "But knowledge is power. It gives you control." In Summer 2009, she and her husband will be riding their motorcycle to participate in the largest motorcycle rally in the US in Sturgis, South Dakota.

"I have a full life," Lynda says. "I've got places to go."

Harley-Davidson Motorcycles is a registered trademark of H-D Michigan, Inc.

Mike N.

Mike N. didn't think men could get breast cancer until he was diagnosed at the age of 48. It all began one night when he felt a tender lump in his right breast. If it wasn't for bloody discharge from his nipple, Mike might have ignored the lump altogether. Concerned, he visited a breast surgeon, who performed a biopsy after a mammogram and ultrasound were completed. Although rare in men, Mike was diagnosed with breast cancer.

Mike had a significant family history of cancer. His mother was a breast cancer survivor who had been diagnosed in her 40s, only to later pass away from ovarian cancer.

Mike, a sales director at a major corporation who describes himself as being very matter-of-fact, was shocked by his diagnosis but immediately scheduled surgery. Mike underwent mastectomy and sentinel axillary lymph node dissection. Because the sentinel lymph node was positive for cancer, his surgeon completed an axillary lymph node dissection, removing 14 lymph nodes altogether.

After the successful surgery, Mike met with an oncologist to discuss his treatment options. Based on the positive node, Mike's oncologist recommended chemotherapy, and Mike prepared himself for the possible side effects.

Mike underwent his first round of chemotherapy without any immediate difficulty. A week later, he was out of town on business and started to experience severe abdominal pain. Mike was admitted to the ICU at a local hospital and was diagnosed with inflammation of the cecum (a segment of the intestine).

After returning home, his doctors decided that Mike was not healthy enough to resume chemotherapy. Unless the inflammation resolved, Mike would need to have the inflamed segment of intestine removed in order to continue with chemotherapy. They waited for a few weeks, but there was still no improvement.

Because of this quandary and the need to make a decision about the next step in his treatment, Mike's surgeon suggested using the Oncotype DX® Breast Cancer Assay to evaluate the benefit of chemotherapy. Based on a Recurrence Score® result of 3, Mike's oncologist determined that chemotherapy did not offer significant benefit in his case and recommended hormonal therapy with tamoxifen.

Once this decision had been made with the help of the Oncotype DX assay, Mike was very relieved. "It's reassuring knowing that chemo isn't something that I have to take a risk with," he says.

While Mike was seeking information about his diagnosis, he realized that there isn't much information or literature available for men who have breast cancer. He also met some barriers when seeking pre-approval for Oncotype DX testing from his insurance company. "They told me, 'Because you're a man, it's not covered. If you were a woman, you would be covered.'" But Genomic Health's Financial Assistance Program offered to appeal directly to his insurance company, or to work out a payment plan.

Today, with the support of his wife, three children, and work colleagues, Mike feels healthy and continues treatment with tamoxifen. Even though Mike thinks that he was fortunate, he recognizes the obstacles he personally experienced as a male breast cancer patient and has some valuable advice for "Men [who] go too long without going to see their doctors. I took the time to have it checked out. I encourage my buddies to do the same."

Gretchen M.

Some people's greatest fear is flying, but not Gretchen M., a vivacious retired flight attendant who made a career of helping passengers feel at ease while up in the air. But when she faced a breast cancer diagnosis last year, it was Gretchen's turn to experience fear and a loss of control.  Gretchen had no family history of breast cancer and had never known anyone else who was diagnosed with the disease.

When she went for her yearly mammogram, a suspicious lesion that neither she nor her doctor could feel was discovered in her right breast.  After that, "everything happened at record speed," she says. Gretchen's breast surgeon confirmed the diagnosis of breast cancer with a needle biopsy after further imaging with an ultrasound. Shortly after, she underwent surgical treatment with a right partial mastectomy and sentinel axillary lymph node dissection.

Gretchen's surgery was performed, and her cancer was identified as node-negative. as identified was cancer and performed, surgery>type DX^®. Some initial lab results had indicated that she would be a candidate for chemotherapy, but the results from Oncotype DX testing suggested that Gretchen would not benefit from chemotherapy.

Gretchen was ecstatic. "I felt 20 pounds lighter. But it made me wonder, 'How many people have endured chemo when they didn't need to?'" Gretchen returned to her surgeon to thank him. "I told him that he saved my life with the surgery and by thinking of the Oncotype DX test."

Gretchen completed radiation therapy and continues on hormonal treatment with an aromatase-inhibitor. Although she had to appeal to her insurance company to cover the cost of the Oncotype DX test, she says that Genomic Health's Genomic Access Program supported her by helping to communicate with her insurance company, which ultimately covered the test in full.

Nearly a year after her initial diagnosis, Gretchen continues to do well.  She has embraced her passion for interior decorating and will begin taking classes in the fall. "Interior decorating is a God-given talent. Everyone is always asking me to help them fix up their homes, and it is a bright spot to lend a hand at something I enjoy."  When she isn't helping out her friends, she enjoys water aerobics and walking her two shih-tzu dogs.  

Coree H.

In 2009, Coree H., a flight attendant and mother of three in Toronto, had her annual mammogram. When the results came back negative, she and her family were relieved. Her mother had lost a hard battle with breast cancer and for Coree, there was always a lingering fear that she too would be diagnosed. Later that year at her annual physical, due to Coree's dense breast tissue and family history, her physician ordered a precautionary MRI. Unlike the mammogram, the results from her MRI revealed a 1.5 centimeter tumor. When her tumor was biopsied, breast cancer was confirmed. Looking back, Coree was grateful for her doctor's persistence. "In my case, I was incredibly lucky because my doctor insisted I receive additional screening. My journey was significantly altered due to her foresight."

After Coree's surgery, she and her oncologist discussed the Oncotype DX® breast cancer test. At the time, her health plan in Ontario, Canada did not cover the diagnostic test, but Coree was not deterred as she wanted to understand the individual characteristics of her tumor. "I'm not sure why, but when my doctor explained that my test results would come back in numerical form, ranging from 0-100, with a zero being the best case scenario, I started focusing on the number 13 - my daughter's soccer jersey number." When the test came back, she and her doctor had a wonderful surprise: her Recurrence Score® result was a 13.

"What I learned from Oncotype DX, is that I had a low risk of breast cancer recurrence. Receiving a low Recurrence Score meant that I would derive little or no benefit from chemotherapy. The test gave me a great deal of confidence to fight the same disease that took my mother. It was the best news I could receive."

As one of the first patients in Canada to benefit from the Oncotype DX test, Coree is an advocate for other early-stage breast cancer patients who face similar treatment decisions. "My treatment plan was changed due to the additional information provided by the Oncotype DX breast cancer test, and I think this information should be available to every qualified patient."

In early 2010, six months after Coree fought unsuccessfully to have her own test reimbursed by her health plan, the Ontario Health Insurance Program began paying for the test. Although Coree paid for the test herself, she is delighted that other women in her province will now have access to Oncotype DX. "I'm thrilled that other breast cancer patients will be able to benefit from this information!"

Between her 23-year career as a flight attendant and her three teenage girls, Coree is as busy as ever. She and her family love to travel. When she's not flying, most of her time is spent shuttling the girls between competitive soccer, gymnastics or cheerleading. "I adore my girls so much and am so relieved that they didn't have to see me suffer through chemotherapy, and that I was able to keep in-step with their lives."

1. The personal stories on this website are from patients who have had a positive experience following their use of Oncotype DX and are not intended to be representative of the results for all patients who have received the test or all women with early-stage breast cancer. Individual results may vary, and not all patients will find Oncotype DX to be useful in making treatment decisions or in raising their confidence level concerning such treatment decisions. The clinical experiences described here are not intended to suggest an impact of Oncotype DX on the outcomes from treatment for breast cancer.