Sabrina M.’s life was turned upside down in 2011 when she noticed an unusual indentation in one of her breasts. Within weeks of the discovery, the then 40-year-old emergency room nurse and mother of three was told that she had breast cancer. The diagnosis came as a complete shock. “None of the risk factors applied to me,” Sabrina says. “I felt good at the time, I was a runner, and I was eating healthy.”
After she had time to absorb everything, Sabrina’s focus quickly shifted to figuring out a plan that would help her get better. She met with two oncologists to learn about next steps, and both recommended two different, aggressive chemotherapy treatments. Trying to weigh the options felt confusing and stressful, especially with the pressure to act quickly. “I didn’t know what to do,” Sabrina says.
Instead of guiding her toward one chemotherapy regimen or another, she sought out a third opinion. It was this oncologist who had a very different recommendation: Try the Oncotype DX Breast Recurrence Score® test, a personalized genomic test designed to help determine her risk of distant recurrence and whether she may or may not benefit from chemotherapy. Sabrina agreed to take the test, and the information it provided ultimately shaped her treatment plan.
The Breast Cancer Test That Made A Difference
At the time of her diagnosis, Sabrina had never heard of the Oncotype DX Breast Recurrence Score test—a key tool in breast cancer care that has informed treatment decisions for more than two million patients worldwide. This test is indicated for patients with early-stage, HR+, HER2-negative stage I-IIIa breast cancers like Sabrina’s. It analyzes 21 genes (16 cancer related genes and 5 reference genes) in a person’s breast cancer tumor that provides insights into distant recurrence risk and likelihood that a patient will benefit from chemotherapy in addition to endocrine therapy.
Before the Oncotype DX Breast Recurrence Score test, oncologists relied on factors like tumor size, grade (how aggressive the cancer appears), and whether it had spread to nearby lymph nodes to make treatment recommendations. “But as we’ve learned more [about breast cancer], we know that genes are actually what matter,” says Marcela Mazo Canola, MD, an oncologist and assistant professor of medicine based in San Antonio who specializes in breast cancer care and research.
Sometimes tiny tumors can turn out to have ultra aggressive genes that cause a person’s breast cancer to come roaring back after treatment. In other cases, tumors with less aggressive genes can be squashed without chemotherapy as part of their endocrine therapy regimen. Understanding the genomic portion of the disease lets us decide the approach to treatment, Dr. Mazo Canola says. “I often tell people, we can decide what’s right for you.”
The test uses tissue or tumor samples that are taken during a patient’s biopsy or surgery, so there’s no need for additional procedures. The samples are sent to a lab for analysis, and based on the findings and other factors, a patient is assigned a personalized Recurrence Score® result. The process takes about 2 weeks. The lower the Recurrence Score result, the lower the likelihood of your cancer coming back somewhere else in your body if you take endocrine therapy alone and the higher the Recurrence Score result, the higher the likelihood of your cancer coming back. As your Recurrence Score result increases, the magnitude of chemotherapy benefit also increases.
Sabrina’s Results And Next Steps
Sabrina knew she would do whatever it took to beat her breast cancer, even if that meant enduring rounds of chemotherapy and the side effects that often come with it. “I didn’t want to do it, but I was prepared. I had gone wig shopping and everything,” she says.
The results of her Oncotype DX Breast Recurrence Score test meant that she wouldn’t have to wear the wig after all. With a Recurrence Score® result of 10, Sabrina and her oncologist concluded that chemotherapy wasn’t a necessary part of Sabrina’s treatment plan. Instead, she was prescribed a short course of radiation followed by five years of a hormone therapy drug. Having a background in medicine herself, Sabrina felt reassured that the recommendations were evidence-based. “I felt much more comfortable that this test used a sample from my tumor so the results felt more personalized to me,” she says.
Sabrina took the drug for five years and completed her treatment in 2021. While it wasn’t always easy (the drug can cause side effects including menopausal symptoms, nausea, and fatigue), “I felt lucky to not have to do chemotherapy,” she says. “Nobody wants to have to go through that if they don’t have to.”
Knowing she’s at a low risk for recurrence, Sabrina doesn’t spend much time worrying about whether her cancer will come back. She’s more focused on making every moment count. She got involved with breast cancer advocacy work and went back to school to earn her PhD in nursing. Now she’s an oncology nurse navigator who helps guide breast cancer patients through clinical trials. “I learned that you have to enjoy every day,” she says. “I want to enjoy today.”
The Power of Knowledge
The Oncotype DX Breast Recurrence Score test was relatively new when it was offered to Sabrina in 2011. Today, it’s a standard of care for patients with early-stage breast cancer, backed by more than two decades of clinical evidence. In fact, it remains the only genomic test proven to predict chemotherapy benefit. “In my practice, we do it with everybody that meets the criteria,” Dr. Mazo Canola says.
The test’s performance has been consistently validated across diverse populations—ensuring it can help inform treatment decisions regardless of race or ethnicity—and is used in more than 100 countries.
Dr. Mazo Canola, Sabrina, and many other oncologists and breast cancer patients who rely on the test say access to more information can help shape treatment plans. When you and your cancer team understand the genomics of your cancer, you can make the best possible decisions for your care. “Don’t go on the assumption that you automatically need chemotherapy,” Dr. Mazo Canola says. Instead, see if there’s more information that you should be considering. It could end up changing the course of your treatment—and your life.
If you’ve been diagnosed with early-stage breast cancer, ask your doctor if the Oncotype DX Breast Recurrence Score test is right for you. Visit breastcancerclarity.com to learn more.
*Sabrina is an ODX Patient Ambassador