The OncotypeDX Recurrence Score (RS) is a 21-gene assay used in hormone-receptor-positive, HER2-negative, node-negative breast cancer. Based on the TAILORx trial, in women aged ≥50 with RS 11–25, the recommended treatment is:

• A Chemotherapy plus endocrine therapy for all patients
• B Endocrine therapy alone is non-inferior to chemoendocrine therapy for RS 11–25 in women ≥50 ✓
• C Chemotherapy alone without endocrine therapy in RS >25
• D Endocrine therapy alone is appropriate for all RS 0–100 in postmenopausal women

Explanation

TAILORx (NEJM 2018) showed that for women with HR+/HER2− pN0 early breast cancer and an RS of 11–25, endocrine therapy alone was non-inferior to chemoendocrine therapy in women aged ≥50 years. Women <50 with RS 16–25 had some chemotherapy benefit. RS ≤10: endocrine therapy alone for all; RS 26–100: chemotherapy + endocrine therapy for all. This trial dramatically reduced chemotherapy use in intermediate-RS patients.

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

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Written and medically reviewed by the StethoPrep medical team.