The Oncotype DX® recurrence score (RS) for ER-positive, HER2-negative, node-negative breast cancer stratifies chemotherapy benefit. A patient with RS of 18 (low) is classified as which risk group, and what is the standard treatment recommendation?

• A Low risk; endocrine therapy alone without chemotherapy ✓
• B High risk; adjuvant chemotherapy + endocrine therapy required
• C Intermediate risk; chemotherapy should be added if age <50
• D Low risk; no treatment needed beyond surgery

Explanation

The TAILORx trial defined RS 0–25 as low risk for women ≥50 years, where endocrine therapy alone is non-inferior to chemo + endocrine therapy. RS ≤18 identifies patients who derive no meaningful benefit from adjuvant chemotherapy regardless of age. Endocrine therapy (tamoxifen or aromatase inhibitor) remains standard. RS >25 indicates high risk where chemotherapy adds significant benefit.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.