Oncotype DX® Breast Recurrence Score
AGE67

67 Year-Old Female Patient

with 1.8 cm Tumor

Patient Details

Post-Menopausal
Lobular
1.8 cm
ER positive
PR positive
Negative
1
Negative
ECOG 1
Positive ≥ 6.5
Positive ≥ 5.5
Negative < 10.7
TREATMENT GIVEN: Radiation followed by Arimidex , follow up in 3 mo

Clinical Experience

PROGNOSIS AND PREDICTION

The Distant Recurrence Risk at 9 Years (Prognosis), in patients with N–, ER+ breast cancer treated with endocrine therapy alone, is provided by the TAILORx1 trial for RS 0-25 and by the NSABP B-142 trial for RS 26-100. Risk is for individual RS results. The 95% confidence intervals for distant recurrence at 9 years are ±2% or less for RS 0-22, and range from ±3% to ±11% as RS increases from 23-50. The TAILORx trial enrolled 10,273 patients and 5,018 patients with RS 0-25 were treated with endocrine therapy (tamoxifen or an aromatase inhibitor) alone. The NSABP B-14 trial enrolled 668 patients who were treated with tamoxifen alone.

The Absolute Benefit of Chemotherapy for all ages is provided by the TAILORx trial for RS 11-25 and by the NSABP B-203 trial for RS 0-10 and RS 26-100. Results for the reduction in distant recurrence at 9 years are for the TAILORx-defined RS groups 0-10, 11-25, and 26-100. TAILORx trial enrolled 10,273 patients and 6,711 were randomized to endocrine therapy (tamoxifen or an aromatase inhibitor) alone or endocrine therapy plus chemotherapy (including anthracyclines and/or taxanes). The NSABP B-20 clinical trial enrolled 651 patients who were randomized to treatment with tamoxifen alone or tamoxifen plus CMF/MF chemotherapy. The magnitude of the absolute benefit of chemotherapy was ~6% at RS 26, and increased as the RS results increased from 26-100, with an average absolute benefit of ~24% and a conservative group estimate of >15% based on the width of the confidence intervals.

Clinical Experience Prognosis Image

Exploratory Subgroup Analysis for TAILORx and NSABP B-20 indicate that RS and age are the strongest predictors of chemotherapy benefit. The absolute reduction of distant recurrence from chemotherapy for patients >50 years and =50 years is shown here for RS groups: 11-15, 16-20, and 21-25 from TAILORx, and 0-10 and 26-100 from NSABP B-20.

Clinical Experience Predication Image

Estimated Chemotherapy Benefit for Individual Recurrence Score Results

Recurrence Score ranges shown reflect randomized patients in NSABP B-20 and TAILORx.

Prognosis and Chemotherapy Benefit Image

Quantitative hormone receptor analysis

Quantitative Single-Gene Scores for quality control. The Oncotype DX test uses quantitative RT-PCR to determine the RNA expression of ER, PR, and HER2, using the published validated cut-offs4. The standard deviations of single-gene results are less than 0.5 units. The RT-PCR single-gene results may differ from ER, PR, or HER2 results reported using other methods or reported by other laboratories.

ER Score11.1
ER Score Image
PR Score8.3
PR Score Image
HER2 Score8.5
HER2 Score Image

References

1. Sparano et al. N Engl J Med. 2018.; ECOG and Genomic Health (data on file).
2. Paik et al. N Engl J Med. 2004.
3. Paik et al. J Clin Oncol. 2006.; Sparano and Paik J Clin Oncol. 2008.
4. Badve et al. J Clin Oncol. 2008.; Baehner et al. J Clin Oncol. 2010.

Disclaimer: These case studies are brought to you for educational purposes only and should not be interpreted as an endorsement of Genomic Health or its services by the submitting physician, or any other product or therapy. The information is sometimes related to interpretive diagnostic opinions of the treating physicians, and is not intended to represent the “standard of care.” The case studies reflect real life cases of patients who have used Oncotype DX, however they are individual results and results do vary. The examples are not necessarily representative of all of those who will use our clinical tests. Genomic Health does not endorse any of the contributors featured on this site.

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NODE
Negative
AGE67
Recurrence Score®15
ER Score11.1
PR Score8.3
HER2 Score8.5