Join Us

Oncotype DX Genomic Tests

Save as Favorite
Sign in to receive recommendations (Learn more)

Leer esta página en español

There are two types of Oncotype DX tests:

  • The Oncotype DX Breast Recurrence Score Test for people diagnosed with early-stage, estrogen-receptor-positive, HER2-negative invasive breast cancer
  • The Oncotype DX Breast DCIS Score Test for people diagnosed with DCIS (ductal carcinoma in situ)

Learn about:

What are genomic tests?

Genomic tests analyze a sample of a cancer tumor to see how active certain genes are. The activity level of these genes affects the behavior of the cancer, including how likely it is to grow and spread. Genomic tests are used to help make decisions about whether more treatments after surgery would be beneficial.

While their names sound similar, genomic testing and genetic testing are very different.

Genetic testing is done on a sample of your blood, saliva, or other tissue and can tell if you have an abnormal change (also called a mutation) in a gene that is linked to a higher risk of breast cancer. See the Genetic Testing pages for more information.

Back to top

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:

  • to help doctors figure out a person’s risk of early-stage, estrogen-receptor-positive breast cancer coming back in a part of the body away from the breast (distant recurrence)
  • to help figure out if a person will benefit from chemotherapy

The results of the Oncotype DX Breast Recurrence Score Test, combined with other features of the cancer, can help you make a more informed decision about whether or not to have chemotherapy to treat early-stage, hormone-receptor-positive, HER2-negative breast cancer.

Back to top

Who is eligible for the Oncotype DX Breast Recurrence Score Test?

You may be a candidate for the Oncotype DX Breast Recurrence Score Test if:

  • you’ve recently been diagnosed with stage I, stage II, or stage IIIa invasive breast cancer
  • the cancer is estrogen-receptor-positive
  • the cancer is HER2-negative
  • the cancer is lymph node-positive or lymph node-negative (meaning you may be eligible for the test whether or not the cancer is in the lymph nodes)
  • you and your doctor are making decisions about chemotherapy

Most early-stage, estrogen-receptor-positive, HER2-negative breast cancers are treated with hormonal therapies, such as an aromatase inhibitor or tamoxifen, after surgery to reduce the risk that the cancer will come back in the future. Whether or not chemotherapy is also necessary has been an area of uncertainty for patients and their doctors.

If you’ve been diagnosed with early-stage, estrogen-receptor-positive, HER2-negative breast cancer, the Oncotype DX Breast Recurrence Score Test can help you and your doctor make a more informed decision about whether or not you will benefit from chemotherapy.

Back to top

How does the Oncotype DX Breast Recurrence Score Test work?

The Oncotype DX Breast Recurrence Score Test analyzes the activity of 21 genes that can influence how likely a cancer is to grow and respond to treatment.

Looking at these 21 genes can provide specific information on:

  • the likelihood that the breast cancer will return
  • whether you’re likely to benefit from chemotherapy to treat early-stage invasive breast cancer

So, the Oncotype DX Breast Recurrence Score Test is both a prognostic test, since it provides more information about how likely (or unlikely) the breast cancer is to come back, and a predictive test, since it predicts the likelihood of benefit from chemotherapy or radiation therapy treatment. Studies have shown that Oncotype DX Breast Recurrence Score Test is useful for both purposes.

The Oncotype DX Breast Recurrence Score Test assigns a Recurrence Score — a number between 0 and 100 — to the early-stage breast cancer. Based on your age, you and your doctor can use the following ranges to interpret your results for early-stage invasive cancer.

For women older than 50 years of age:

  • Recurrence Score of 0-25: The cancer has a low risk of recurrence. The benefits of chemotherapy likely will not outweigh the risks of side effects.
  • Recurrence Score of 26-100: The cancer has a high risk of recurrence. The benefits of chemotherapy are likely to be greater than the risks of side effects.

For women age 50 and younger:

  • Recurrence Score of 0-15: The cancer has a low risk of recurrence. The benefits of chemotherapy likely will not outweigh the risks of side effects.
  • Recurrence Score of 16-20: The cancer has a low to medium risk of recurrence. The benefits of chemotherapy likely will not outweigh the risks of side effects.
  • Recurrence Score of 21-25: The cancer has a medium risk of recurrence. The benefits of chemotherapy are likely to be great than the risks of side effects.
  • Recurrence Score of 26-100: The cancer has a high risk of recurrence. The benefits of chemotherapy are likely to be greater than the risks of side effects.

You and your doctor will consider the Recurrence Score in combination with other factors, such as the size and grade of the cancer and the number of hormone receptors the cancer cells have (many vs. few). Together, you can make a decision about whether or not you should have chemotherapy.

Back to top

What is the Oncotype DX Breast DCIS Score?

DCIS is the most common form of non-invasive breast cancer. DCIS usually is treated by surgically removing the cancer (lumpectomy in most cases). After surgery, hormonal therapy may be recommended if the DCIS is hormone-receptor-positive (most are).

Radiation therapy may be recommended for some women. Doctors aren’t always sure which women will benefit from radiation therapy.

The Oncotype DX Breast DCIS Score is used:

  • to help doctors figure out a woman’s risk of DCIS coming back (recurrence) and/or the risk of a new invasive cancer developing in the same breast
  • how likely a woman is to benefit from radiation therapy after DCIS surgery

The results of the Oncotype DX Breast DCIS Score Test, combined with other features of the DCIS, can help you and your doctor make a more informed decision about whether or not you need radiation therapy.

Back to top

Who is eligible for the Oncotype DX Breast DCIS Score Test?

You may be a candidate for the Oncotype DX Breast DCIS Score Test if:

  • you’ve recently been diagnosed with DCIS
  • you’re having lumpectomy to remove the DCIS or have had a core biopsy

Back to top

How does the Oncotype DX Breast DCIS Score Test work?

The Oncotype DX Breast DCIS Score Test analyzes the activity of 12 genes that can influence how likely the DCIS is to come back, either as another DCIS or as invasive breast cancer.

The Oncotype DX Breast DCIS Score Test assigns a Recurrence Score — a number between 0 and 100 — to the DCIS. You and your doctor can use the following ranges to interpret your results for DCIS:

  • Recurrence Score lower than 39: The DCIS has a low risk of recurrence. The benefit of radiation therapy is likely to be small and will not outweigh the risks of side effects.
  • Recurrence Score between 39 and 54: The DCIS has an intermediate risk of recurrence. It’s unclear whether the benefits of radiation therapy outweigh the risks of side effects.
  • 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.

You and your doctor will consider the Recurrence Score in combination with other factors, such as the size and grade of the DCIS and the number of hormone receptors the cancer cells have (many vs. few). Together, you can make a decision about whether or not you should have radiation therapy.

Back to top

Insurance coverage and financial assistance for Oncotype DX tests

The Medicare program and several other major insurance companies cover the Oncotype DX tests. According to Genomic Health, about 90% of insured people in the United States are members of a plan that covers these tests. If you discover that your plan does not cover the Oncotype DX test that’s right for you, talk to your doctor; he or she may be able to work with your insurance company to get the test covered. If you have a low Recurrence Score and you and your doctor decide you do not need to have chemotherapy or radiation, your insurance company can save much more than the cost of the test.

Genomic Health also has started the Genomic Access Program to assist you with verifying insurance coverage and obtaining reimbursement. If you do not have or cannot secure insurance coverage, the Genomic Access Program still may be able to help. 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. For insurance- and payment-related questions, call 1-866-ONCOTYPE (1-866-662-6897) or email customerservice@genomichealth.com.

Back to top

Other genomic tests

There are other genomic tests used to analyze breast cancer tumors. To learn more, click on the links below.

  • The Breast Cancer Index test is used to predict the risk of node-negative, or node-positive with one to three positive nodes, hormone-receptor-positive breast cancer coming back 5 to 10 years after diagnosis, as well as if a person would benefit from an additional 5 years of hormonal therapy.
  • The EndoPredict test is used to predict the risk of distant recurrence of early-stage, hormone-receptor-positive, HER2-negative breast cancer that is either node-negative or has up to three positive lymph nodes.
  • The MammaPrint test is used to predict the risk of recurrence within 10 years after diagnosis of stage I or stage II breast cancer that is hormone-receptor-positive or hormone-receptor-negative.
  • The Prosigna Breast Cancer Prognostic Gene Signature Assay (formerly called the PAM50 test) is used to predict the risk of distant recurrence for postmenopausal women within 10 years of diagnosis of early-stage, hormone-receptor-positive disease with up to three positive lymph nodes after 5 years of hormonal therapy.

Back to top

Written by: Jamie DePolo, senior editor


Was this article helpful? Yes / No

Did you know Breastcancer.org is a nonprofit? Donations from individuals make it possible for us to publish the most reliable, complete, and up-to-date information about breast cancer. Please make a donation online today or text HELPBCO to 243725 to donate via your mobile device. Message and data rates may apply.
Rn icon

Can we help guide you?

Create a profile for better recommendations



How does this work? Learn more
Are these recommendations helpful? Take a quick survey

2021eg sidebarad v01
Back to Top