title: A retrospective study of the impact of 21-gene recurrence score assay on treatment choice in node positive micrometastatic breast cancer.
abstract: To assess clinical utility of the 21-gene assay (Oncotype DX® Recurrence Score®), we determined whether women with HER2(-)/ER+ pN1mi breast cancer with low (<18) Recurrence Scores results are given adjuvant chemotherapy in a lower proportion than those with high scores (≥31). This was a multicenter chart review of ≥18 year old women with pN1mi breast cancer, HER2(-)/ER+ tumors, ductal/lobular/mixed histology, with the assay ordered on or after 1 January 2007. One hundred and eighty one patients had a mean age of 60.7 years; 82.9% had ECOG performance status 0; 33.7% had hypertension, 22.7% had osteoporosis, 18.8% had osteoarthritis, and 8.8% had type-2 diabetes. Mean Recurrence Score was 17.8 (range: 0-50). 48.6% had a mastectomy; 55.8% had a lumpectomy. 19.8% of low-risk group patients were recommended chemotherapy vs. 57.9% in the intermediate-risk group and 100% in the high-risk group (p < 0.001). A total of 80.2% of the low-risk group were recommended endocrine therapy alone, while 77.8% of the high-risk group were recommended both endocrine and chemotherapy (p < 0.001). The Oncotype DX Recurrence Score result provides actionable information that can be incorporated into treatment planning for women with HER2(-)/ER+ pN1mi breast cancer. The Recurrence Score result has clinical utility in treatment planning for HER2(-)/ER+ pN1mi breast cancer patients.
authors: Main Line HealthCare Breast Surgical Specialists, Susquehanna Bank Building, 101 South Bryn Mawr Ave, Suite 201, Bryn Mawr, PA 19010, USA. tgf@tgfsurgery.com.
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authors: Penn State Hershey Breast Center, Penn State College of Medicine, 30 Hope Drive, MC EC008, P.O. Box 859, Hershey, Pennsylvania 17033, USA. jsmith9@hmc.psu.edu.
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authors: Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA. Christine.Laronga@moffitt.org.
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authors: The George Washington University, GW Medical Faculty Associates, 2300 M Street, NW 8th floor, DC Level, Washington, DC 20037, USA. amcswain@mfa.gwu.edu.
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authors: The George Washington University, GW Medical Faculty Associates, 2300 M Street, NW 8th floor, DC Level, Washington, DC 20037, USA. cteal@mfa.gwu.edu.
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authors: The Maine Center for Cancer Medicine, 100 Campus Drive, unit 108, Scarborough, Maine 04074, USA. weisbt@mccm.org.
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authors: Genomic Health, Inc., 301 Penobscot Drive, Redwood City, CA 94063, USA. tgf@tgfsurgery.com.
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authors: Genomic Health, Inc., 301 Penobscot Drive, Redwood City, CA 94063, USA. tgf@tgfsurgery.com.
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authors: Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Suite 404, Beverly Hills, CA 90212, USA. dasha@pharllc.com.
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authors: Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA. Kevin.Fox@uphs.upenn.edu.
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authors: Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Suite 404, Beverly Hills, CA 90212, USA. tgf@tgfsurgery.com.
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authors: Partnership for Health Analytic Research, LLC, 280 S. Beverly Drive, Suite 404, Beverly Hills, CA 90212, USA. tgf@tgfsurgery.com.
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