A 48-year-old woman has a 2.2 cm grade 2 invasive ductal carcinoma, ER+/PR+/HER2−, with clear sentinel nodes. Her Oncotype DX recurrence score is 18. According to TAILORx trial data, what is the recommended management?

• A Chemotherapy followed by endocrine therapy
• B Endocrine therapy alone ✓
• C Chemotherapy alone
• D Radiotherapy and endocrine therapy without systemic chemotherapy

Explanation

TAILORx demonstrated that for node-negative, hormone receptor-positive, HER2-negative breast cancer with recurrence score 0–25, endocrine therapy alone is non-inferior to chemo-endocrine therapy in women ≥50 years. A score of 18 falls in the intermediate range (11–25) where chemotherapy provides no benefit in postmenopausal women. This transformed the management of the largest subgroup of breast cancer.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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