Oncotype DX®

Is Testing Right for Me? I Have My Test Results

Oncotype DX®

How Testing Works for Oncotype DX®

Oncotype DX® testing is done shortly after surgery (biopsy, lumpectomy, or mastectomy). You don't need any extra blood work or special procedures. The test only needs a small sample of the tumor tissue taken during surgery.

When you have surgery to remove breast cancer, all of the removed tissue is sent to a lab for processing. The tissue is preserved in a fixative solution and put into paraffin blocks. A pathologist looks at the tissue samples to see if it looks like all the cancer was removed. He also looks for other features of the cancer.

If you decide to have the Oncotype DX test, the pathologist helps choose the best tissue sample for testing. The sample needs to be mostly breast cancer tissue. The sample goes to the Genomic Health Laboratory, which is the only laboratory that does Oncotype DX testing.

Oncotype DX Gene Expression

Oncotype DX testing measures the activity level of 21 different genes in breast tumors. This is called gene expression testing. These measurements let the laboratory see what factors are driving a cancer. They predict how a cancer is likely to behave in the future.

Genes Tested with OncotypeDX

ProliferationEstrogenInvasionHER2OtherReference
K1-67ERStromelysin 3GRB7GSTM1Beta-actin
STK 15PRCathepsin L2HER2CD68GAPDH
SurvivinBcl2  BAG1RPLPO
Cyclin B1SCUBE2   GUS
MYBL2    TFRC

  • Proliferation genes control the growth and division of the cell.
  • Estrogen-signaling genes control how the cell grows in response to estrogen.
  • Invasion genes control the cell's ability to invade other tissues, like the lungs and liver. 
  • HER2 receptor genes control how the cell grows in response to growth factors.
  • Reference genes are normal genes expressed in breast tissue. They are the standard control.

Together, these measurements give you a Recurrence Score® that ranges from 0 to 100. The Recurrence Score predicts how aggressive the cancer is and how likely it is to come back within 10 years. A low risk is a score less than 18. A high risk is 31 or higher. Anything in between is an intermediate risk.

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