title: Impact of Oncotype DX Recurrence Score on Treatment Decisions: Results of a Prospective Multicenter Study in Turkey.
abstract: BACKGROUND
  Breast cancer is the most common malignancy among Turkish women and the rate of early stage disease is increasing. The Oncotype DX(®) 21-gene assay is predictive of distant recurrence in ER-positive, HER2-negative early breast cancer. We aimed to evaluate the impact of the Recurrence Score(®) (RS) on treatment decisions and physician perceptions in Turkey. We also studied correlations between RS and routine risk factors.
  
  
  METHODS
  Ten academic centers across Turkey participated in this prospective trial. Consecutive breast cancer patients with pT1-3, pN0-N1mic, ER-positive, and HER2-negative tumors were identified at multidisciplinary tumor conferences. The initial treatment decision was recorded before tumor blocks were sent to the central laboratory. Each case was brought back to tumor conference after receiving the RS result. Both pre- and post-RS treatment decisions and physician perceptions were recorded on questionnaire forms. Correlations between RS and classical risk factors were evaluated using univariate and multivariate analyses.
  
  
  RESULTS
  Ten centers enrolled a total of 165 patients. The median tumor size was 2 cm. Of 165 patients, 57% had low RS, 35% had intermediate RS, and 8% had high RS, respectively. The overall rate of change in treatment decision was 33%. Initially, chemotherapy followed by hormonal therapy (CT+HT) was recommended to 92 (56%) of all patients, which decreased to 61 (37%) patients post-RS assay (p<0.001). Multivariate analysis indicated that progesterone receptor (PR) and Ki-67 scores were significantly related to RS.
  
  
  CONCLUSIONS
  Oncotype DX testing may provide meaningful additional information in carefully selected patients.
authors.affiliation: Department of Surgery, Istanbul University.
authors.forename: Vahit
authors.initials: V
authors.lastname: Ozmen
authors.affiliation: Medical Department, EORTC.
authors.forename: Ajlan
authors.initials: A
authors.lastname: Atasoy
authors.affiliation: Department of Internal Medicine, Division of Medical Oncology, Ege University.
authors.forename: Erhan
authors.initials: E
authors.lastname: Gokmen
authors.affiliation: Department of Internal Medicine, Division of Medical Oncology, Akdeniz University / Memorial Hospital Antalya.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozdogan
authors.affiliation: Department of Internal Medicine, Division of Medical Oncology, Hacettepe University Institute of Oncology.
authors.forename: Nilufer
authors.initials: N
authors.lastname: Guler
authors.affiliation: Department of General Surgery, Acibadem University Maslak.
authors.forename: Cihan
authors.initials: C
authors.lastname: Uras
authors.affiliation: Department of General Surgery, Erciyes University.
authors.forename: Engin
authors.initials: E
authors.lastname: Ok
authors.affiliation: Department of General Surgery, Cukurova University / Acibadem University Adana.
authors.forename: Orhan
authors.initials: O
authors.lastname: Demircan
authors.affiliation: Department of Internal Medicine, Division of Medical Oncology, Dicle University.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Isikdogan
authors.affiliation: Department of Medicine, Division of Medical Oncology, Istanbul University.
authors.forename: Pinar
authors.initials: P
authors.lastname: Saip
keywords: adjuvant treatment; breast cancer; decision impact; genomic testing; oncotype dx