How much does the OncoType Dx test cost?
The Oncotype DX test costs about $4,000. The Genomic Access Program (GAP) can help you navigate insurance coverage and payment options for the test, as well as answer any questions you may have. This program also covers financial assistance for those without insurance.
Is the Oncotype DX DCIS test cost-effective?
Study Looks at Cost-Effectiveness of Oncotype DX DCIS Test. Recurrence Score greater than 54: The DCIS has a high risk of recurrence, and the benefits of radiation therapy are likely to be greater than the risks of side effects. The Oncotype DX DCIS test is expensive, usually costing more than $3,000 in the United States.
What is the Oncotype DX breast Recurrence Score test?
The Oncotype DX Breast Recurrence Score Test analyzes the activity of a group of genes that can affect how an early-stage breast cancer is likely to behave and respond to treatment. The Oncotype DX Breast Recurrence Score Test is used in two ways:
What is Oncotype DX used for?
Oncotype DX tests help doctors predict the future activity of cancer by analyzing genes in samples of breast, prostate, or colon cancer cells. The test results can help determine the risk of metastasis, which is when cancer appears or returns to a distant part of the body.
Does Medicare cover Oncotype test?
Medicare and most private insurance carriers cover the Oncotype DX Breast Recurrence Score test for eligible patients with early-stage invasive breast cancer.
How much does Oncotype DX testing cost?
Various forms of financial assistance and payment plans are available for people facing financial hardships or those who are uninsured or underinsured. The Oncotype DX test costs about $4,000.
How accurate is Oncotype DX test for breast cancer?
The studies showed that 99% of those with low Oncotype DX scores who were primarily treated using hormonal therapy alone, WITHOUT chemotherapy, were cancer free after 5 years. To date, more than 170,000 breast cancer patients have changed their treatment decision based the Oncotype DX test.
Is the Breast Cancer Index test the same as Oncotype?
Isn't Breast Cancer Index the same thing? No. Oncotype DX predicts likely benefit from chemotherapy. Breast Cancer Index is a test that predicts whether you are likely to benefit from an additional 5 years of anti-estrogen medication.
What is a good Oncotype score?
A score of 15 or smaller means you have a low risk of the cancer returning if you get hormone treatment. You probably will not benefit from receiving chemotherapy. A score between 16 and 20 means you have a low to medium risk of the cancer returning if you get hormone treatment.
What treatment would you recommend if the Oncotype DX test score is 10?
A prospective study shows that women with an Oncotype DX test Recurrence Score between 0 and 10 can safely be treated only with hormonal therapy, allowing them to skip chemotherapy.
How much does chemo reduce risk of recurrence?
'Patients who received chemotherapy every two weeks were 17% less likely to have disease recurrence and 15% less likely to die from breast cancer within 10 years, compared with those who received treatment every three weeks.
What stage is invasive ductal carcinoma?
Generally, the stage of invasive ductal carcinoma is described as a number on a scale of I through IV. Stages I, II, and III describe early-stage cancers, and stage IV describes cancers that have spread outside the breast to other parts of the body, such as the bones or liver.
Where is the first place breast cancer spreads?
The lymph nodes under your arm, inside your breast, and near your collarbone are among the first places breast cancer spreads. It's “metastatic” if it spreads beyond these small glands to other parts of your body.
Is the Breast Cancer Index test covered by Medicare?
Breast Cancer Index® Now Covered by Medicare for a Broader Group of Post-Menopausal Patients Considering Extended Endocrine Therapy.
Is Breast Cancer Index covered by insurance?
The Medicare program and several other major insurance companies have agreed to cover the Breast Cancer Index test. Biotheranostics, the company that makes the Breast Cancer Index test, has a Patient Services Team to help you with verifying insurance coverage and understanding any out-of-pocket costs.
Should I have the Oncotype DX test?
When should I have the Oncotype DX test? You should have the test done when you and your doctor agree that the test results will be helpful for making decisions about chemotherapy treatment.
Oncotype DX Breast Recurrence Score results
The Oncotype DX Breast Recurrence Score eligibility looks at the activity of 21 genes. It provides you with a recurrence score from 0 to 100.
Oncotype DX Breast DCIS Score results
The DCIS test analyzes the activity of 12 genes. This test also gives you a score from 0 to 100. Here’s how the results are interpreted:
Prostate cancer Oncotype DX results
The prostate cancer Oncotype DX test analyzes 12 genes to produce a score from 0 to 100 correlating with the aggressiveness of your cancer.
Colon cancer Oncotype DX results
The colon cancer Oncotype DX test analyzes 12 genes and provides a score from 0 to 100 indicating your risk of reoccurrence. The test also provides you with the odds of your cancer returning with 3 years or within 5 years.
Document Information
CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.
CMS National Coverage Policy
Title XVIII of the Social Security Act (the “Act”), Section 1862 (a) (1) (A). This section limits coverage and payment to those items and services that are reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
Coverage Guidance
This contractor will provide limited coverage for the Oncotype DX® DCIS assay (Genomic Health, Inc., Redwood City, CA) for women diagnosed with DCIS who are planning on having breast conserving surgery and considering adjuvant radiation therapy.
