There are no racial disparities in Oncotype DX (ODX) testing for patients with node-negative early breast cancer for whom ODX testing is guideline recommended and widely covered by insurers, a new study published online ahead of print in the Journal of Clinical Oncology has shown. However, blacks with node-positive breast cancer, for whom ODX testing is not recommended, access ODX testing less often than non-black women.1
ODX is a tumor gene-profiling test that aids in decision-making for patients requiring adjuvant chemotherapy for breast cancer. Because ODX has the potential to improve quality of care, researchers sought to evaluate whether disparities exist in ODX testing uptake.
For the study, researchers analyzed data from the phase 3 Carolina Breast Cancer Study that included a total of 2998 North Carolina women whose breast cancer was diagnosed between 2008 and 2014. Of those, 1468 had estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative, stage 1 or 2 breast cancer.
Researchers found that black patients had higher-grade and larger tumors, more comorbidities, younger age at diagnosis, and lower socioeconomic status than non-black women.
A total of 42% of women had ODX test results in their pathology reports, with those women more likely being younger and having medium tumor size.
Results also showed that no racial disparities exist in ODX uptake among those with node-negative disease, but black patients with node-positive disease were 46% less likely to receive ODX testing compared with non-black women.
1. Roberts MC, Weinberger M, Dusetzina SB, et al. Racial variation in the uptake of Oncotype DX testing for early-stage breast cancer [published online ahead of print November 23, 2015]. J Clin Oncol. doi:10.1200/JCO.2015.63.2489.