Journal Article
. 2014 Feb;14(3).
doi: 10.1016/j.clbc.2013.12.002.

Impact of oncotype DX recurrence score in the management of breast cancer cases

Michaela T Nguyen 1 Alexander Stessin 2 Himanshu Nagar 2 Timothy M D'Alfonso 1 Zhengming Chen 3 Tessa Cigler 4 Mary Kay Hayes 2 Sandra J Shin 5 
  • PMID: 24486121
  •     12 citations


Background: Oncologists have used clinicopathologic features to guide treatment decisions for their breast cancer patients; however, more recently, results of multigene assays are also being considered. A popular assay, Oncotype DX (Genomic Health), stratifies node-negative breast cancer patients into groups that are at low, intermediate, or high risk for distant recurrence and guides decisions about adjuvant chemotherapy utilization.

Objective: We studied the impact of Oncotype DX recurrence score (ODxRS) compared with that of clinicopathologic features on adjuvant chemotherapy utilization in node-negative breast cancer patients and in node-positive breast cancer patients, and we evaluated whether clinicopathologic features impact the decision for adjuvant chemotherapy utilization in a subset of node-negative breast cancer patients with an intermediate-risk ODxRS.

Methods: A retrospective study from a single academic institution was performed on 425 patients with invasive breast carcinoma.

Results: Adjuvant chemotherapy utilization most significantly correlated with a high-risk ODxRS (P < .0001) and, to a lesser degree, patient's age and tumor size. No statistically significant association was found between ODxRS and adjuvant chemotherapy utilization in a subset of patients. In the 156 node-negative breast cancer patients with intermediate-risk ODxRS, high tumor grade most significantly correlated with adjuvant chemotherapy utilization (P < .0001).

Conclusion: ODxRS, if available, heavily impacts adjuvant chemotherapy utilization and more so than any clinicopathologic factor in node-negative breast cancer patients. Node-negative breast cancer patients in the intermediate-risk group whose tumors were high grade were more likely to receive adjuvant chemotherapy.

Keywords: Adjuvant chemotherapy; Intermediate risk score; Multigene assay; Node-negative; Node-positive.

Breast cancer in young women: special considerations in multidisciplinary care.
Chantal Reyna, Marie Catherine Lee.
J Multidiscip Healthc, 2014 Oct 11; 7. PMID: 25300196    Free PMC article.
Patterns of 21-gene assay testing and chemotherapy use in black and white breast cancer patients.
Vanessa B Sheppard, Suzanne C O'Neill, +3 authors, Claudine Isaacs.
Clin Breast Cancer, 2015 Jan 04; 15(2). PMID: 25555816    Free PMC article.
Adjuvant Chemotherapy Use and Health Care Costs After Introduction of Genomic Testing in Breast Cancer.
Andrew J Epstein, Yu-Ning Wong, +6 authors, Peter W Groeneveld.
J Clin Oncol, 2015 Nov 26; 33(36). PMID: 26598749    Free PMC article.
Underutilization of gene expression profiling for early-stage breast cancer in California.
Rosemary D Cress, Yingjia S Chen, +2 authors, Kenneth W Kizer.
Cancer Causes Control, 2016 Apr 22; 27(6). PMID: 27097910    Free PMC article.
21-gene recurrence assay in patients receiving intraoperative radiotherapy: are "favorable" characteristics a surrogate for low recurrence?
Bridget A Oppong, Surupa Sen Gupta, +6 authors, Shawna C Willey.
Gland Surg, 2018 Jan 06; 6(6). PMID: 29302485    Free PMC article.
Oncotype testing in patients undergoing intraoperative radiation for breast cancer.
Kelsey E Larson, Stephanie A Valente, +7 authors, Stephen R Grobmyer.
Mol Clin Oncol, 2018 Oct 23; 9(5). PMID: 30345048    Free PMC article.
Impact of adjuvant chemotherapy on the survival of patients with breast cancer diagnosed by screening.
Irene Zarcos-Pedrinaci, Maximino Redondo, +12 authors, REDISSEC-CaMISS Group.
Cancer Med, 2019 Sep 25; 8(15). PMID: 31549794    Free PMC article.
Features, Outcomes, and Management Strategies of Male Breast Cancer: A Single Institution Comparison to Well-Matched Female Controls.
Joseph Liu, Anupama Suresh, +18 authors, Robert Wesolowski.
Eur J Breast Health, 2020 Jul 14; 16(3). PMID: 32656521    Free PMC article.
BCL-2 expression aids in the immunohistochemical prediction of the Oncotype DX breast cancer recurrence score.
Mark D Zarella, Rebecca C Heintzelman, Nikolay K Popnikolov, Fernando U Garcia.
BMC Clin Pathol, 2018 Dec 24; 18. PMID: 30574014    Free PMC article.
21-Gene Recurrence Score Assay and Outcomes of Adjuvant Radiotherapy in Elderly Women With Early-Stage Breast Cancer After Breast-Conserving Surgery.
San-Gang Wu, Wen-Wen Zhang, +4 authors, Zhen-Yu He.
Front Oncol, 2019 Feb 15; 9. PMID: 30761267    Free PMC article.
Adjuvant Chemotherapy for Patients with Breast Cancer Based on Clinical and Evolving Oncotype DX Criteria.
Jamal Zekri, Meteb Al-Foheidi, +2 authors, Ayman Rasmy.
Breast Care (Basel), 2021 Jan 16; 15(6). PMID: 33447239    Free PMC article.
How Canadian Oncologists Use Oncotype DX for Treatment of Breast Cancer Patients.
Xiaofu Zhu, Susan Dent, +5 authors, Xinni Song.
Curr Oncol, 2021 Feb 10; 28(1). PMID: 33557029    Free PMC article.