Oncologists are using the 21-gene recurrence score assay to personalize treatment for patients with early-stage, hormone receptor-positive breast cancer, including those with node-positive disease, a study published in the journal Cancer has shown.1

The recurrence score assay stratifies early stage, estrogen receptor-positive breast cancer by recurrence risk; however, few studies have assessed how clinicians use the recurrence score to recommend adjuvant systemic therapy or patients’ experiences with testing decision-making.

For the study, investigators surveyed 3880 women treated for breast cancer between 2013 and 2014 who were included in the Los Angeles County and Georgia Surveillance, Epidemiology, and End Results registries. Questionnaires examined chemotherapy recommendations, receipt of chemotherapy, testing experiences, and decision satisfaction.

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Of the 1527 patients with stage I/II, estrogen receptor/progesterone receptor-positive, HER2-negative disease who responded to the survey, 778 received a recurrence score. Of those, 62.6% had node-negative, favorable disease, 24.3% had node-negative, unfavorable disease, and 13.0% had nose-positive disease (P <.001).

Results showed that 47.2% of patients received a recommendation against chemotherapy, while 40.5% received a recommendation for chemotherapy.

Researchers found that recurrence score was associated with recommendations. Specifically, 86.9% to 96.5% of patients with high scores (31-100) received a chemotherapy recommendation, whereas 65.9% to 78.2% of those with low scores (0-18) received a recommendation against it. Proportions ranged across clinical subgroups.

In addition, 87.0% to 100% of patients with high recurrence scores received chemotherapy compared with only 2.9% to 26.6% of those with low scores.

The study also demonstrated that the majority of women were satisfied with the recurrence score and their decision to receive or not receive chemotherapy.


1. Friese CR, Li Y, Bondarenko I, et al. Chemotherapy decisions and patient experience with the recurrence score assay for early-stage breast cancer. Cancer. 2016 Oct 24. doi: 10.1002/cncr.30324. [Epub ahead of print]