A 60-year-old postmenopausal woman is diagnosed with ER-positive, HER2-negative, grade 2 invasive ductal carcinoma of 1.8 cm, N0, M0. Oncotype DX recurrence score is 12. What is the MOST appropriate adjuvant treatment?
- A Chemotherapy followed by hormone therapy
- B Chemotherapy alone without hormone therapy
- C Hormone therapy (aromatase inhibitor) alone — chemotherapy provides no additional benefit ✓
- D Observation — no adjuvant treatment needed for small tumours
Correct answer: C. Hormone therapy (aromatase inhibitor) alone — chemotherapy provides no additional benefit
Explanation
The TAILORx trial demonstrated that postmenopausal women with HR-positive, HER2-negative, node-negative breast cancer and Oncotype DX recurrence score ≤25 (and especially ≤17) derive no benefit from adjuvant chemotherapy and can be safely treated with endocrine therapy alone. A score of 12 falls in the low-risk group (<18), where chemotherapy adds no benefit over endocrine therapy. Aromatase inhibitors (anastrozole, letrozole) are the endocrine therapy of choice in postmenopausal women.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.