1. What is the Oncotype DX test?
2. Who is Oncotype DX for?
3. Why is it used? 
4. How does it work?
5. Oncotype DX score
6. Availability and cost
7. Oncotype DX for DCIS

1. What is the Oncotype DX test?

Oncotype DX is a test that predicts how likely breast cancer is to come back after surgery and the likely benefit of having chemotherapy.

The test gives a score between 0 and 100, and people who score above a certain number are more likely to be offered chemotherapy (see Oncotype DX score).

2. Who is Oncotype DX for?

The test is suitable for people recently diagnosed with early stage breast cancer that:

The test may also be considered for some people whose breast cancer affects one to three lymph nodes under the arm. 

The test isn’t suitable for people whose breast cancer is oestrogen receptor negative or HER2 positive. 

3. Why is it used?

Your specialist may consider recommending the Oncotype DX test if the benefit of chemotherapy for you is less clear.

Chemotherapy may be given after surgery to reduce the risk of breast cancer coming back in future.

Whether you’re offered chemotherapy depends on a number of features of your breast cancer. These include the size and grade of the cancer; whether it has spread to any of the lymph nodes under the arm; and whether the cancer is hormone receptor and HER2 positive or negative.

For some people the benefit of chemotherapy is clear, but for others it’s less clear.

4. How does it work?

The test is done on a small amount of breast cancer tissue removed during your surgery and doesn’t involve having any more tissue removed. The tissue is sent to a laboratory in the USA, where the test is carried out. The test looks at groups of genes found in breast cancer.

The results are given separately from your pathology report and are sent to your specialist within 10–14 days. 

If your specialist has recommended you have hormone therapy before surgery, the test must be done on cancer cells removed before you start hormone therapy. 

5. Oncotype DX score

The test gives a score, known as a recurrence score, from 0 to 100. 

The higher the score, the more likely breast cancer is to come back and the more likely you are to benefit from having chemotherapy as well as hormone therapy. 

Your specialist will use the score, along with other information about your breast cancer, to help decide whether chemotherapy would benefit you. 

A recent study of the test suggests that women with a score of 0 to 25 who are over the age of 50 won’t get any benefit from having chemotherapy in addition to hormone therapy.

Women who have a score of 26 or above and are over the age of 50 are likely to benefit from having chemotherapy in addition to hormone therapy.

The same study suggests that women with a score of 0 to 15 who are aged 50 or under won’t get any benefit from having chemotherapy in addition to hormone therapy.

If you have a score of 16 or above and are aged 50 or under, your specialist will discuss your test result with you to help decide if you’re likely to benefit from chemotherapy.

6. Availability and cost

If Oncotype DX is suitable for you, it is usually available on the NHS across the UK.

Most private healthcare companies will also cover the cost of the test. 

You can also pay for the test yourself, but your specialist team will need to order the test for you and will be sent the results to discuss with you. It costs around £3,000. 

7. Oncotype DX test and DCIS

There’s a specific Oncotype DX test for people with ductal carcinoma in situ (DCIS) who have had breast-conserving surgery (also known as wide local excision or lumpectomy).

There’s currently no guidance for using this test within the NHS as there’s less evidence of its benefits for people with DCIS.

Oncotype DX for DCIS predicts the risk of the cancer coming back after surgery. The results of this test can help you and your specialist team decide whether you’re likely to benefit from radiotherapy.

Some private healthcare providers may cover the cost and you can also pay for the test yourself. For more information, talk to your specialist team.  

Last reviewed: January 2019
Next planned review begins 2021

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