A 52-year-old woman with ER+/PR+/HER2- breast cancer has a Recurrence Score of 28 on OncotypeDx. According to the TAILORx trial findings, what is the recommended treatment strategy?
- A Chemotherapy alone without endocrine therapy
- B Endocrine therapy alone is sufficient
- C Endocrine therapy with consideration of adding chemotherapy, as this score is in the intermediate range where chemotherapy benefit is uncertain ✓
- D Chemotherapy followed by endocrine therapy
Correct answer: C. Endocrine therapy with consideration of adding chemotherapy, as this score is in the intermediate range where chemotherapy benefit is uncertain
Explanation
The TAILORx trial established that for hormone receptor-positive, HER2-negative, node-negative breast cancer, OncotypeDx Recurrence Scores of 0-10 can receive endocrine therapy alone, scores of 11-25 receive endocrine therapy alone (with modest benefit from chemotherapy for younger women), and scores 26+ derive significant benefit from chemotherapy. A score of 28 falls in the high-risk range where chemotherapy in addition to endocrine therapy is recommended. The trial changed practice by confirming many patients can safely omit chemotherapy.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.