A 45-year-old woman with a T2N1M0 ER-positive, HER2-negative breast cancer has a 21-gene recurrence score (Oncotype DX) of 18. According to the TAILORx trial findings, the most appropriate adjuvant systemic treatment is:
- A Endocrine therapy alone ✓
- B Chemotherapy followed by endocrine therapy
- C Trastuzumab plus endocrine therapy
- D Chemotherapy alone
Correct answer: A. Endocrine therapy alone
Explanation
The TAILORx trial demonstrated that for node-negative, ER-positive, HER2-negative patients with a recurrence score of 0–25, endocrine therapy alone was non-inferior to chemotherapy plus endocrine therapy, especially in women over 50. A score of 18 falls in the low-intermediate range where chemotherapy does not add benefit. Trastuzumab is only indicated for HER2-positive disease.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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