Have you been recently diagnosed with DCIS?

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Have you been recently diagnosed with DCIS? Jen D. A busy mother of two and active community volunteer. Jen D. A busy mother of 2 and active community volunteer. *DCIS = Ductal carcinoma in situ AnAn educational educationalguide guide prepared preparedbyby Genomic Genomic Health Health

The Oncotype DX test solidified the direction I wanted to go. I think I would have been considerably more uncertain about my final decision without knowing the DCIS Score result. -Jen D. Diagnosed with DCIS. 2

Have you recently been diagnosed with a non-invasive form of breast cancer called ductal carcinoma in situ (DCIS)? Are you struggling to understand what your treatment options are? DCIS is a commonly diagnosed breast condition and rarely lifethreatening. It is considered to be an early, non-invasive form of breast cancer. Ductal carcinoma means the tumor is within the milk ducts In situ means it is in its original place and has not spread beyond the ducts It is overwhelming to get the diagnosis, but DCIS is treatable. After therapy, some women with DCIS are still at risk for the cancer coming back in the same breast (local recurrence) as either DCIS or invasive breast cancer. Planning Your Treatment After a diagnosis of DCIS, the first step is usually surgery to remove the DCIS tumor. Following surgery, the next step is to determine how likely your cancer is to return, which may help you and your doctor make decisions about future treatment options. 3

4

Make the Right Treatment Decision for You There are several treatments for DCIS after surgery, so it is important to gather as much information as possible to decide on a treatment plan that is right for you. Your doctor may consider many factors in planning your treatment, including: your medical history your age size, grade and surgical margin width of your DCIS tumor whether your tumor cells have estrogen receptors the results of your Oncotype DX test your treatment preferences Because every woman s DCIS is unique, understanding the tumor biology will help you and your doctor personalize your treatment plan. 5

How Is the Oncotype DX Test Performed? The test is performed on a small amount of your DCIS tumor tissue that was removed during your original surgery (lumpectomy, or core biopsy). This tissue is routinely saved and stored at the hospital where you had your surgery. You will NOT have to go through any additional surgery or procedure to get the Oncotype DX test. When Should the Test Be Done? It is important that your doctor request the Oncotype DX test before you start any treatment, since the test is intended to help determine how likely your cancer is to return, which may guide treatment decisions. 6

What Is the Oncotype DX Test? The Oncotype DX Breast DCIS Score is a unique diagnostic test that measures a group of cancerrelated genes in your DCIS tumor. The test gives you a DCIS Score result, which provides you information regarding the chance that the cancer may come back in the same breast. Why Should I Consider this Test? This test provides information specific to your tumor, not available from traditional factors. Since the test provides individualized information, it enables the treatment plan to be tailored specifically for you. It gives you and your doctor a better understanding of how your DCIS tumor behaves. Speak with your healthcare team to understand how the Oncotype DX test results may impact your treatment planning. Is the Test Right for Me? You may be a candidate for the test if you meet both of these criteria: You have been recently diagnosed with DCIS and are making treatment decisions with your doctor You have had a lumpectomy or biopsy 7

8 One of the most important resources was learning that I had a higher risk of recurrence (because my DCIS Score was high), so I chose radiation as part of my treatment plan. Most important were my physicians (who were aware of the importance of the Oncotype DX test) my friends, my peers, and most of all my family. -Carol F., a medical nurse and grandmother. Diagnosed with DCIS.

How Do I Get the Oncotype DX Test? The test can only be ordered by a licensed healthcare professional, such as your doctor. You may wish to talk with your healthcare team and ask if the test may be of benefit to you. How Long Will It Take to Get the Results? Most results from the Oncotype DX test are available within 7 to 14 days from the date the tumor sample is received by the Genomic Health laboratory. The results are sent to your doctor so that he or she can discuss the results with you and answer your questions. Is the Test Covered by Insurance? The Oncotype DX test is covered by Medicare and private insurance coverage varies. In addition, Genomic Health offers the Genomic Access Program (GAP), a comprehensive program designed to help you with the coverage process and provide financial assistance when necessary, based on eligibility. Please call (866) ONCOTYPE (866-662-6897) for more information on insurance and for financial-aid questions. 9

Understanding Your DCIS Score Result Your doctor will receive a report with the results of your Oncotype DX test that contains your DCIS Score result. DISTRIBUTION OF DCIS SCORE RESULTS (0-100) Low High A lower DCIS Score result means: Your cancer is less likely to come back in 10 years A higher DCIS Score result means: Your cancer is more likely to come back in 10 years It is important to understand that a lower DCIS Score result does not mean that there is no chance that your breast cancer will return. Also, a higher DCIS Score result does not mean that your breast cancer will definitely return. The results also provide additional information, such as the activity levels of hormone receptors in your tumor, which may also help guide your treatment. 10

NOTES 11

For insurance, financial aid, or other questions about the Oncotype DX test, please call US (English) 866-ONCOTYPE (866-662-6897), US (Spanish) 877-444-9876, and international 001-650-569-2080. For more information about this and other Oncotype DX tests, please visit genomichealth.com or oncotypedx.com. This educational piece is not designed to provide individual advice in connection with your diagnosis or treatment plan. Such matters should be discussed with your healthcare provider. The people shown in this booklet used the Oncotype DX DCIS test in making their treatment decisions with their physicians. Learn more about the patient stories at MyBreastCancerTreatment.org Genomic Health, Oncotype DX, Oncotype DX Breast DCIS Score, Oncotype IQ, and DCIS Score are trademarks or registered trademarks of Genomic Health, Inc. 2016 Genomic Health, Inc. All rights reserved. GHI10176_0716