Rounds with the Investigators 2012 | Breast Cancer

DR NEIL LOVE: The second kind of similar case that this physician wanted some input on was a 36-year-old woman with a 2.4-centimeter, ER-positive, HER2-negative tumor. And actually, I guess this physician went ahead and did an Oncotype. The problem is, now the insurance company won’t pay for it, but interestingly, the Oncotype’s low and, as a result, the patient’s not going to get chemo. And the physician pointed out in her note to us how ironic it is that the insurance company won’t pay for something that actually theoretically would save money.

But just looking over this case, Sara — again, 2.4 centimeters: Would you have sent an Oncotype and followed it?

DR SARA HURVITZ: I would have, after a discussion with the patient. As I indicated earlier, I, in the absence of Oncotype, would have treated her with adjuvant chemotherapy. And so I agree with the physician who sent this in that the Oncotype, while being a more expensive laboratory test to be ordering — I think it’s close to $3,800, if not more now, each time you do it — is saving her all of the toxicity and the cost associated with chemo and chemo-related adverse events.