Oncotype DX recurrence score in node-positive patients in the post-RxPONDER era: A single-institution experience Journal Article


Authors: Han, R.; Brogi, E.; Thompson, D.; El-Tamer, M.; Morrow, M.; Wen, H. Y.
Article Title: Oncotype DX recurrence score in node-positive patients in the post-RxPONDER era: A single-institution experience
Abstract: Purpose: RxPONDER showed that in postmenopausal women with early-stage hormone receptor + /HER2- breast cancer (BC) with 1–3 positive axillary lymph nodes (LN) and a recurrence score ≤ 25, the addition of chemotherapy to endocrine therapy did not improve distant recurrence-free survival. We sought to evaluate Oncotype DX recurrence score (ODX RS) distribution in LN negative and LN positive patients aged ≥ 50 years (y) and to determine clinicopathologic factors associated with RS. Methods: ODX RS, demographic, and pathologic information was collected for patients with ER + /HER2- BC with 0 (patients < 50y) or 0–3 positive (patients ≥ 50y) LN treated at our institution between January 2021 and December 2022. Statistical analyses were conducted using Pearson chi-square and two-tailed t tests. Results: The study cohort included 2378 BC from 2285 women. Among women ≥ 50y, there was no significant difference in RS distribution between pN0, pN1mi, and pN1a patients; with 85.4%, 86.5%, and 81% having a RS ≤ 25, respectively. Among LN + women ≥ 50y, RS > 25 was significantly associated with higher grade (P =.001), lower ER (P =.007), and lower PR (P <.001). Among LN- women ≥ 50y, RS > 25 was significantly associated with higher grade (P <.001), lower ER (P <.001), and lower PR (P <.001). Conclusion: ODX RS distribution among LN + and LN- women aged ≥ 50y was similar. In this population, RS is significantly associated with tumor grade, ER, and PR, regardless of LN status. In our post-RxPONDER era cohort, over 80% of women aged ≥ 50y with early-stage ER + /HER2- BC with ≤ 3 positive axillary LN would be spared chemotherapy based on RS, regardless of nodal status. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.
Keywords: adult; cancer chemotherapy; major clinical study; recurrence risk; breast cancer; cohort analysis; pathology; information processing; axillary lymph node; data analysis; tumor growth; postmenopause; recurrence free survival; demographics; human; female; article; oncotype dx recurrence score; node positive; rxponder trial; rxponder analysis
Journal Title: Breast Cancer Research and Treatment
Volume: 211
Issue: 2
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2025-06-01
Start Page: 449
End Page: 454
Language: English
DOI: 10.1007/s10549-025-07661-2
PUBMED: 40025384
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Monica Morrow
    777 Morrow
  2. Hannah Yong Wen
    307 Wen
  3. Mahmoud B. El-Tamer
    105 El-Tamer
  4. Edi Brogi
    522 Brogi
  5. Rachel Hae-Sung Han
    6 Han