A 50-year-old woman with a 2 cm ER-positive, HER2-negative invasive ductal carcinoma undergoes breast conservation surgery. The tumor has lymphovascular invasion and is grade 3. Her Oncotype DX recurrence score is 35. Based on the TAILORx and RxPONDER trials, what is the recommended adjuvant systemic treatment?
- A Chemotherapy followed by endocrine therapy ✓
- B Endocrine therapy alone
- C Trastuzumab plus endocrine therapy
- D Observation only
Correct answer: A. Chemotherapy followed by endocrine therapy
Explanation
An Oncotype DX recurrence score of 35 (high risk, greater than 25) indicates significant benefit from adding chemotherapy to endocrine therapy. TAILORx showed no chemotherapy benefit for RS 0-25 in node-negative patients. Trastuzumab is indicated only for HER2-positive disease. Observation is inappropriate for invasive carcinoma.
Reference: Harris, Diseases of the Breast, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.