Oncotype DX

What is Oncotype DX?

Oncotype DX is a test that can help your specialist team decide if you would benefit from having chemotherapy as part of your treatment and how likely it is that your cancer will return in the future.

Whether you are offered chemotherapy depends on various features of the cancer such as its size, grade (how different the cells look under the microscope compared to normal cells and how quickly they are growing) and whether the lymph nodes under the arm are affected. Oncotype DX provides information in addition to these factors that might guide the decision about chemotherapy in some cases.

The test is carried out on breast tissue removed during surgery.

Who may benefit from having an Oncotype DX test?

People recently diagnosed with primary, invasive breast cancer (that started in the breast and is not known to have spread to other parts of the body) may benefit from the test. The cancer should be:

• stage 1 or 2 (the extent of the spread of the cancer and its size are known as the stage)
• lymph node negative (the lymph nodes under the arm are not affected)
• oestrogen-receptor positive (ER+) (some breast cancers have receptors within the cell that bind to the female hormone oestrogen and stimulate the cancer to grow).

Sometimes the test may be considered for post-menopausal women recently diagnosed with lymph node positive and ER+ primary breast cancer.

How does it work?

The test analyses a group of 21 genes found in breast cancer and results are reported as a Recurrence Score ranked between 0 and 100. 

This score indicates how likely the cancer is to return and whether chemotherapy (in addition to hormone therapy) will benefit the patient.

The lower the score, the less likely the cancer is to come back. The higher the score, the more likely the cancer is to come back.

Your specialist team can then use this information to help decide whether you will benefit from chemotherapy.

How is the test performed?

• Oncotype DX is carried out on a small amount of breast cancer tissue removed during surgery.
• The tissue sample is shipped to a licensed laboratory in California, USA, where the test was developed.
• The analysis is converted into the Recurrence Score, a number between 0 and 100.
• Within 10-14 days, the results are sent to your specialist.

Is the test available in the UK?

Oncotype DX is not generally available through the NHS unless as part of a clinical trial, although its use is currently being reviewed by the National Institute for Health and Clinical Excellence (NICE). Some private healthcare companies may cover the cost of the test.

Self funding is sometimes possible (approximately £2,500). Your specialist team will advise you if the test is appropriate for you.