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I just had a lumpectomy and sentinel node removal and had clear margins but there was a tiny amount of cancer found in my sentinel lymph node. So tiny that the docs are debating whether or not I should undergo TC. Radiation is definitely in my future but they are unsure if the benefit would outweigh all the toxic chemicals to my body considering my specific case could be arguable either way. My insurance denied our request for the Oncotype test because there was not data on women who were… read more
I had it I n 2 out of 8 no chemo or radiation. Had onco with low scor, I believe a 12. My nurse case manager called insurance and told them they could pay the 3000.00 and possibly not need chemo or they could just spent the hundred thousand on chemo, they paid for the test! I had the best nurs case manager, part of my insurance.
@A MyBCTeam Member your insurance was wrong. You met all the criteria to get OncotypeDx done in order to determine whether or not you would benefit (in term of recurrence prevention) with chemotherapy. I got tested in 2017 while being perimenopausal. I am just like you ER+ PR+ HER2-
Here are the eligibility criteria
You may be a candidate for the Oncotype DX Breast Recurrence Score Test if:
1. you’ve recently been diagnosed with stage I, stage II, or stage IIIa invasive breast cancer
the cancer is estrogen receptor-positive
2. the cancer is HER2-negative
3. the cancer is lymph node-positive or lymph node-negative (meaning you may be eligible for the test whether or not the cancer is in the lymph nodes)
Just go for the grievance process with your insurance. The test will require your tumor slides to be sent to the company in order for them to genotype it and give you the score. The test itself costs around 5K but the over all cost for chemotherapy and its long term effects on your quality of life is much more. If you need additional info on Oncotype and other NGS tests please let me know
ALWAYS get a second opinion!!
My insurance also denied my ONCOtype test but my oncologist and oncological surgeon banded together and fought them for me. I got the test done and I did not need chemo as my score was on the low end.
I also had it in one out of 4 nodes removed. I wasn't even asked if I wanted the oncotype testing done. My onc just had it done. Now the company that did it says my insurance co. doesn't want to pay for it. But it did help determine if I should have chemo or not. My score was an 24, so it wasn't low enough to say no chemo. So I am having the dose dense chemotherapy.
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