title: Physician survey of the effect of the 21-gene recurrence score assay results on treatment recommendations for patients with lymph node-positive, estrogen receptor-positive breast cancer.
abstract: OBJECTIVE
  To survey the effect of the 21-gene recurrence score (RS) assay results on adjuvant treatment recommendations for patients with lymph node-positive (N+), estrogen receptor-positive (ER+) breast cancer.
  
  
  METHODS
  Medical oncologists who ordered the 21-gene RS assay were invited to complete a survey regarding their most recent patient with N+/ER+ breast cancer. We obtained responses from 160 (16%) of the 1,017 medical oncologists.
  
  
  RESULTS
  Most of the respondents were in community (71%) versus academic (25%) settings and had practiced for a median of 11 years. T1, T2, or T3 disease was reported in 62%, 35%, and 3% of patients, respectively. One, two, three, or ≥ 4 nodes were reported in 69%, 18%, 6%, and 3% of patients, respectively. Eighty-six percent of the oncologists made treatment recommendations before obtaining the RS; 51% changed their recommendations after receiving the RS. In 33%, treatment intensity decreased from chemotherapy plus hormonal therapy to hormonal therapy alone. In 9%, treatment intensity increased from hormonal therapy alone to chemotherapy plus hormonal therapy. In 8%, treatment recommendations changed in a way that did not fit the definition of either increased or decreased intensity.
  
  
  CONCLUSIONS
  In this survey of physician practice, the RS result was used to guide adjuvant treatment decision making in N+/ER+ breast cancer more often in patients with tumors less than 5 cm in size and one to three positive lymph nodes than in patients with larger tumors and four or more positive nodes and yielded an overall reduction in recommendations for chemotherapy.
authors: New York University School of Medicine, New York, NY; Division of Hematology-Oncology, Department of Medicine, and Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles; Pardee RAND Graduate School, RAND Corporation, Santa Monica; Genomic Health, Redwood City; Partnership for Health Analytic Research, Los Angeles, CA.
authors: Ruth
authors: R
authors: Oratz
authors: Benjamin
authors: B
authors: Kim
authors: Calvin
authors: C
authors: Chao
authors: Stanley
authors: S
authors: Skrzypczak
authors: Caron
authors: C
authors: Ory
authors: Roberto
authors: R
authors: Bugarini
authors: Michael
authors: M
authors: Broder