Oncotype DX® Breast Recurrence Score

38 Year-Old Female Patient

with 2.5 cm tumor

Patient Details

2.5 cm
ER positive
PR positive
Positive (1-3)
Excellent health, no chronic medical problems
Positive ≥ 6.5
Positive ≥ 5.5
Negative < 10.7
TREATMENT GIVEN: Surgery followed by chemo treatment

Clinical Experience


The Distant Recurrence Risk at 9 Years (Prognosis), in patients treated with tamoxifen or arimidex alone, is provided by the TransATAC1 trial. Risk is for individual RS results. The 95% confidence intervals for distant recurrence at 9 years are ±3 to ±6% for RS 0-22, and range from ±6 to ±12% as RS increases from RS 23-50. The TransATAC trial enrolled 1,231 patients and 243 patients had 1-3 positive nodes, including micrometastases.

The Absolute Benefit of Chemotherapy is provided by the SWOG 88142 trial. Results for reduction in distant recurrence or death at 5 years are for the RS groups 0-17, 18-30, and 31-100. The SWOG 8814 trial enrolled 367 patients with N+ (including micrometastases), ER+ breast cancer who were randomized to tamoxifen alone or tamoxifen plus CAF (anthracycline-containing) chemotherapy. The benefit of chemotherapy increased with an increase in the RS result. The upper bound of the 95% confidence interval for RS 18-30 was 7% absolute chemotherapy benefit.

Clinical Experience Prognosis Image

Real World Evidence of SEER Registry Outcomes in Patients Treated Without Chemotherapy Based on RS Results. SEER had 6,814 patients with HR+, HER2-, node positive (1-3 positive nodes or micrometastases) breast cancer, diagnosed between January 2004 and December 2014, who were reported to have no or unknown chemotherapy use. Two additional prospective studies also demonstrated favorable outcomes with endocrine therapy alone for patients with 1-3 positive nodes and RS 0-11 (PlanB3) or RS 0-17 (Clalit4).

Clinical Experience Predication Image

Estimated Chemotherapy Benefit for Individual Recurrence Score Results

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 Score8.1
ER Score Image
PR Score6.3
PR Score Image
HER2 Score8.6
HER2 Score Image


1. Dowsett et al. J Clin Oncol. 2010.
2. Albain et al. Lancet Oncol. 2010.; Genomic Health (data on file).
3. Nitz et al. Breast Cancer Res Treat. 2017.
4. Stemmer et al. npj Breast Cancer 2017.
5. 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 Exact Sciences 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. Exact Sciences does not endorse any of the contributors featured on this site.

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Positive (1-3)
Recurrence Score®29
ER Score8.1
PR Score6.3
HER2 Score8.6