Stage I-IIIA - Invasive

Hear from Our Patients

Coree's Story

“Genomic testing and the Oncotype DX test gives you the peace of mind and the reassurance that the treatment plan that you and your doctor have decided upon based on your recurrence score is the right one.”

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.

“My treatment plan was changed due to the additional information provided by the Oncotype DX breast cancer test.”

“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.”

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Angela's Story

“My score impacted my treatment journey because it gave me reassurance that it was based on my genes rather than some statistical data.”

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.

“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.”

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.”

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Susan's Story

“I got my Oncotype DX test recurrent score. It was 31. I was in the high risk category, and I knew at that time I needed chemo. This was a chance to personalize my treatment, and I was glad to have that opportunity.”

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.

“Even though I didn’t want to do the chemo, I knew it would lessen the chances of cancer recurring.”

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.

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Mike's Story

“My score impacted my journey by eliminating the doctor’s recommendation for further chemotherapy treatments.”

Mike N. didn't think men could get breast cancer until he was diagnosed at the age of 49. 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.

“It's reassuring knowing that chemo isn't something that I have to take a risk with.”

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 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."

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Gail's Story

“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.”

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.

“I wanted to do it [the test] because I knew it would help me make a treatment plan with my doctor.”

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.”> Oncotype DX 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!

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Lynda's Story

“Knowledge is power. Get as much knowledge as you can get and learn what you can. It's your body.”

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.”

“I had confidence in Genomic Health and trust in my physician”

But after meeting with her oncologist, who told her about Oncotype DX assay, 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 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.

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Katherine's Story

"My recurrence score was 18, and I was so happy to find out that I would not benefit from chemotherapy."

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 assay 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.

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Vilma's Story

“The Oncotype DX test gave me a tangible way to view the benefits of chemotherapy.”

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.

“The Oncotype DX test gave me a tangible way to view the benefits of chemotherapy.”

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. “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.

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