A post-menopausal woman with hormone receptor-positive (ER+/PR+, HER2-negative) node-negative breast cancer is considering adjuvant chemotherapy. The Oncotype DX recurrence score returns as 14. What is the most appropriate management?
- A Adjuvant chemotherapy followed by endocrine therapy
- B Endocrine therapy alone without chemotherapy ✓
- C Neoadjuvant chemotherapy then surgery
- D CDK4/6 inhibitor plus endocrine therapy
Correct answer: B. Endocrine therapy alone without chemotherapy
Explanation
The TAILORx trial showed that post-menopausal women with ER+/HER2-negative, node-negative breast cancer and Oncotype DX recurrence scores of 0-25 derive no benefit from adjuvant chemotherapy; endocrine therapy alone is equivalent. A recurrence score of 14 is in the low-intermediate range (<26), so endocrine therapy alone is appropriate. CDK4/6 inhibitors plus endocrine therapy are indicated in metastatic disease or high-risk early breast cancer, not for low recurrence-score node-negative disease.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.