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Lifetime Friends: Oncotype DX test helps men avoid chemo treatment

4:42 PM, Jul 12, 2010   |    comments
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Tampa, Florida -- Male breast cancer is rare--one in every 1,000 men will be diagnosed. If diagnosed, doctors have a test called Oncotype DX that enables them to give a better prognosis of whether a patient will need chemotherapy.

Despite increased male breast cancer awareness on popular shows like Nip/Tuck, when Ralph Edmond felt a lump and pain in his chest a year and a half ago, he says he initially overlooked it. Eventually, the 67-year-old saw his doctor.

"I went in, and he said very nicely, 'Well, Ralph, I got some bad news for you.' He said, 'You've got breast cancer.' And I was thrown back a loop. For real, I said breast cancer? He said yes," said Ralph.

Ralph went to Moffitt Cancer Center in Tampa for a second opinion.

"He had me take another mammogram, and he confirmed it. It was breast cancer."

In January 2009, Ralph had part of his left breast removed. Dr. John Kiluk ran an Oncotype DX test to spare him any unnecessary treatment.

"It's a very specialized way to evaluate the tumor of the patient and can tell us on a molecular level how likely it is maybe this can spread," Dr. Kiluk said.

"It came back, and it was favorable for me. That was seven percent, so that kind of eliminated me from having to go through the procedure of chemotherapy, which I was very happy about... because with the things I've heard about chemo and things, I didn't want to have to go through that. And thank God I didn't," Ralph said.

Like the vast majority of Dr. Kiluk's male patients, Ralph did not have a family history of cancer, which is why men need to be just as aware as women of any changes in their breasts.

"I tell everybody now. I told my brothers, all of them, feel your chest, man. Every now and then when you're taking a shower, feel it. If you feel something that ain't feeling too good, have it checked," Ralph said.

Here are some male breast cancer symptoms from the Mayo Clinic:

  • A painless lump or thickening in the breast tissue.
  • Changes to the skin covering your breast, such as dimpling, puckering, redness or scaling.
  • Changes to your nipple, such as redness, scaling or a nipple that turns inward.
  • Discharge from your nipple

Here's more about how Oncotype DX evaluates tumors in men and women from breastcancer.org:

Oncotype DX is known as a genomic assay - it looks at groups of genes and how active they are, which can influence how a cancer is likely to grow and respond to treatment. A genomic test is different from a genetic test. A genetic test looks for mutations (unusual changes) in genes that are inherited, or passed from one generation to the next.

The Oncotype DX test uses a sample of your breast tumor tissue to analyze the activity of 21 different genes. Genes control the behavior and activities of all cells, including cancer cells. When cells are behaving abnormally, this can often be traced back to unusual activity by certain genes.

Looking at this set of 21 genes can provide specific information on:

• the likelihood that the breast cancer will return
• whether you are likely to benefit from commonly used chemotherapy regimens

So, Oncotype DX is both a prognostic test, since it provides more information about how likely (or unlikely) the breast cancer is to come back, and a predictive test, since it predicts the likelihood of benefit from chemotherapy treatment. Studies have shown that Oncotype DX is useful for both purposes. The American Society for Clinical Oncology and the National Comprehensive Cancer Network now include the Oncotype DX test in their treatment guidelines for early breast cancer.

If you think you are eligible, talk to your doctor about having the Oncotype DX test. The pathology lab that originally preserved and examined your tumor tissue would need to send out samples to Genomic Health, the company that performs the test. The test involves extracting RNA (part of the genomic makeup of the cells) from the tumor sample and analyzing it to determine the level of activity - or expression - of each of 21 genes.

Based on this analysis, Oncotype DX assigns the breast cancer a Recurrence Score. This score is a number between 0 and 100 that corresponds to a specific likelihood of experiencing breast cancer recurrence within 10 years of your initial diagnosis. The lower your score, the less likely the cancer is to recur. The higher the score, the more likely the cancer is to recur.

Libby Hendren, 10 Connects

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