Clalit Health Services will pay $4,000 to test every woman member with breast cancer who is suited to the Oncotype DX genetic test to determine whether their genetic profile gives them the potential to benefit from special chemotherapy. The largest health fund said that it expects between 250 and 300 Clalit members who meet its criteria will require and want such testing, in which a tissue sample removed in surgery is sent abroad. The test has not been included in the Health Ministry's basket of health services, although it was previously a candidate and rejected. Clalit director-general Zev Vurmbrand called the voluntary decision "a breakthrough and good news for women with breast cancer." Clalit said it was the first health maintenance organization outside the US to offer the Oncotype DX test to its members. The benefit will be available to all "suitable" women with breast cancer in Clalit, and not only to those who pay for its supplementary health insurance. More than 1,000 Clalit members contract breast cancer each year. Clalit said the genetic test can rule out those patients who don't need extra chemotherapy and determine who will benefit from it. It determines the biological changes in the tumor and their influence on growth, ability of the tumor to penetrate blood vessels and lymph glands and its ability to metastasize to other parts of the body. The test looks at the expression of 16 genes connected to breast malignancies and uses five other genes for quality control. These genes were chosen from among a databank of 250. However, asked to comment, a leading oncology expert who specializes in the field said that the Oncotype DX test is "not the treatment standard in the Western world" and not recommended. Instead, if Clalit has the money, it should be invested in other medical technologies for cancer." The spokesman for Maccabi Health Services, the second largest health funds that often boasted about its voluntary introduction of expensive medications and other technologies into its own basket of services that its competitors lacked, said the Oncotype DX is not one of those it has decided to offer to patients at this stage. "We prefer to spend our resources on other proven lifesaving technologies for breast cancer such as Herceptin," he said.