Effect of 21-Gene Recurrence Score Results on Treatment Recommendations in Patients with Lymph Node-Positive, Estrogen Receptor-Positive Breast Cancer

• Published in: Cancer research (Chicago, Ill.) Ill.), 2009-12, Vol.69 (24_Supplement), p.2031-2031
• Main Authors: Oratz, R., Chao, C., Skrzypczak, S., Kim, B., Broder, M.
• Format: Article
• Language: English
• ISSN: 0008-5472; 1538-7445
• DOI: 10.1158/0008-5472.SABCS-09-2031

Background: Results of recent Oncotype DX® studies indicate that the Recurrence Score (RS) can identify node-positive, estrogen receptor-positive (N+/ER+) patients who may not benefit from chemotherapy and have a low risk of distant recurrence with hormonal therapy alone. Based on these results, the Oncotype DX® breast cancer assay has been ordered for N+/ER+ patients. There are no data, however, on the impact of the assay on adjuvant treatment planning in N+ patients. We performed a survey to characterize the effect of the Oncotype DX® breast cancer assay on adjuvant treatment recommendations in N+/ER+ breast cancer.Methods: U.S. medical oncologists (N=1,017) who ordered Oncotype DX® for at least 1 patient with N+/ER+ breast cancer were contacted and asked to complete a web-based survey regarding the single most recent N+/ER+ patient for whom the Oncotype DX® assay was ordered. The survey was developed through cognitive interviews with four medical oncologists, and the protocol was institutional review board approved.Results: We analyzed surveys from 160 individual physicians for 160 N+/ER+ patients. Physicians were in community practices (71%) more often than in academic practice settings, they were equally dispersed geographically, and they had a median of 11 years (range, 1–45) of practice experience. The median patient age was 61 years (range, 34–82), and 79% were postmenopausal. T1, T2, or T3 disease was reported in 62%, 35%, and 3% of patients, respectively (unknown in 1 patient). One, two, three, or 4+ nodes were reported in 69%, 18%, 6%, and 3%, respectively (unknown in 8 patients). Fifty-four percent of N+/ER+ patients had an RS