Iles Kathleen, Roberson Mya L, Spanheimer Philip, Gallagher Kristalyn, Ollila David W, Strassle Paula D, Downs-Canner Stephanie
Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA.
NPJ Breast Cancer. 2022 Mar 1;8(1):27. doi: 10.1038/s41523-022-00394-1.
Oncotype DX (ODX) recurrence score (RS) is a validated tool to guide the use of adjuvant chemotherapy (AC) in hormone receptor+/HER2- breast cancer. In this analysis, we examine (1) characteristics associated with ODX testing and (2) the association between ODX RS and receipt of AC across age and nodal status. Women with HR+/HER2-, early-stage (T1-2, N0-1) breast cancers from 2010-2017 in the National Cancer Database were included. 530,125 met inclusion and 255,971 received ODX testing. Older women were less likely to receive testing; however, nodal positivity increased use of testing. High ODX RS was associated with increased mortality, though the association was not consistent across age and was most strongly associated with mortality among younger, node-negative women. Older women with high ODX RS, regardless of nodal status, were less likely to receive AC. Clinicians may be employing ODX RS to support treatment decisions against the receipt of AC.
Oncotype DX（ODX）复发评分（RS）是一种经过验证的工具，可用于指导激素受体阳性/人表皮生长因子受体2阴性（HR+/HER2-）乳腺癌辅助化疗（AC）的使用。在本分析中，我们研究了（1）与ODX检测相关的特征，以及（2）ODX RS与不同年龄和淋巴结状态下AC接受情况之间的关联。纳入了2010年至2017年国家癌症数据库中HR+/HER2-、早期（T1-2，N0-1）乳腺癌患者。530125例符合纳入标准，其中255971例接受了ODX检测。老年女性接受检测的可能性较小；然而，淋巴结阳性会增加检测的使用。高ODX RS与死亡率增加相关，尽管这种关联在不同年龄并不一致，且在年轻、淋巴结阴性女性中与死亡率的关联最为强烈。无论淋巴结状态如何，ODX RS高的老年女性接受AC的可能性较小。临床医生可能正在使用ODX RS来支持不接受AC的治疗决策。
