A 52-year-old postmenopausal woman with ER-positive, HER2-negative breast cancer (T2N0M0, grade 2) undergoes Oncotype DX testing. The Recurrence Score returns as 18. According to the TAILORx trial results, what is the most appropriate adjuvant systemic treatment?
- A Chemotherapy plus endocrine therapy
- B Chemotherapy alone
- C Endocrine therapy alone ✓
- D No adjuvant treatment required
Correct answer: C. Endocrine therapy alone
Explanation
The TAILORx trial established that in women with hormone-receptor-positive, HER2-negative, node-negative breast cancer with an Oncotype DX Recurrence Score of 0–25, endocrine therapy alone is non-inferior to chemotherapy plus endocrine therapy, with chemo providing minimal benefit in this range for women 51 and older. A score of 18 falls in the intermediate range where endocrine therapy alone is appropriate, especially in postmenopausal women. Chemotherapy adds toxicity without meaningful survival benefit in this scenario.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.