New genetic technology can help breast cancer patients at the OU Cancer Institute make specialized treatment decisions.

A recently developed test, Oncotype DX, evaluates 21 genes in a tumor and develops a personal recurrence score. This score helps predict how effective chemotherapy would be for the patient and the likelihood of recurrence, said Dr. Howard Ozer, chief of hematology and oncology at the OU Cancer Institute.

More than 200,000 cases of breast cancer are diagnosed each year, said Dr. Elizabeth Jett, director of imaging at OU Breast Institute.

After a lumpectomy or mastectomy is used to remove the tumor, oncologists look at the tumor to decide if the woman would benefit from the test, Ozer said.

The ability to decipher between good and bad genes made the new technology possible. Ozer said each gene receives a number, and the sum of all the numbers is the recurrence score.

“Each gene is important in determining the score,” Ozer said.

A high recurrence score is a 30 out of 100, and the patient will likely relapse if the tumor is not treated with chemotherapy, Ozer said.

However, with chemotherapy treatment, the risk for a relapse is reduced to 30 percent, Ozer said.

The new technology allows for individual treatment based on the genetics of the 21 genes carried by the tumor, as opposed to group treatment that was done in the past.

“[Oncotype DX is] the beginning of the ability to focus individual therapeutic decisions on the characteristics of individual patients,” Ozer said.

Ozer said that a large tumor could have no need for the test from Genomic Health, whereas small tumors that were typically characterized as low risk might need to be tested.

“Clinically, a tumor may look identical to another, but genetically it may not,” Ozer said.

Since the approval of the test in 2008, Ozer said at least a dozen of his patients have undergone the test.

Ozer said this test is not needed for all patients. He said he thinks about 10 percent of breast cancer patients will be chosen by oncologists to benefit from the $3,800 test.

“I think this is a very important step for women and for individual patients, not just for breast cancer,” Ozer said.

Ozer said tests show that Oncotype DX might work for other types of cancer as well.

All of the tests are sent to Genomic Health, who test for a recurrence score and sends a report back to doctors. Patients can hold a print-out of their scores and have a visual representation of their build up.

“This really helps us to give direct advice to that patient,” Ozer said.

According to the Genomic Health Web site, test results are available within 10 to 14 days of submitting the tumor.

Jett said women should begin yearly mammograms when they turn 40. She said women should look for changes in their breasts.

“Not every cancer is a firm little ball,” Jett said.

Women whose mothers and sisters were diagnosed with breast cancer before age 50 should begin their yearly mammograms five to 10 years earlier.

“If lumps are found with a mammogram, the smaller it is, the easier it is to catch them,” Jett said.

Jett said the genomic testing will allow women to decide which therapy route is best for them and the test can guide them.