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: | MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- Source: Scopus |
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