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Journals / Turkish Journal of Clinics and Laboratory / 2025 / Cilt: 16 Sayı: 4

Prognostic Value of Oncotype DX Recurrence Score in Early-Stage Hormone Receptor-Positive, HER2-Negative Breast Cancer: A Real-World Experience

Selami Bayram(Memorial Antalya Hospital)0000-0002-0930-5025
Ali Murat Tatlı(Memorial Antalya Hospital)0000-0001-9696-1102
Mustafa Özdoğan(Memorial Antalya Hospital)0000-0001-9512-4828
Pages
555–563
Publication Date
2026-01-01
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⚡ TL;DR(Too Long; Didn't Read)

These findings reinforce the clinical utility of ODx-RS in tailoring adjuvant therapy for early-stage HR+/HER2− breast cancer in real-world practice.

📌 3 Key Takeaways

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Objective & Hypothesis:Background: The Oncotype DX 21-gene recurrence score (ODx-RS) assay guides adjuvant chemotherapy decisions in early-stage hormone receptor-positive (HR+), HER2-negative breast cancer.
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Key Findings & Data:Methods: We retrospectively reviewed 64 female patients diagnosed with pT1–2, pN0–1mic, M0 HR+/HER2− breast cancer who underwent ODx-RS testing at Memorial Antalya Hospital between 2015–2024.
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Conclusion & Impact:These findings reinforce the clinical utility of ODx-RS in tailoring adjuvant therapy for early-stage HR+/HER2− breast cancer in real-world practice.
🔬Design:Review & Systematic Survey
📍Scope:2015–2024 Verileri
⚙️Variables:: breast cancer · Oncotype DX · recurrence score

Abstract

Background: The Oncotype DX 21-gene recurrence score (ODx-RS) assay guides adjuvant chemotherapy decisions in early-stage hormone receptor-positive (HR+), HER2-negative breast cancer. While validated in large clinical trials, real-world data from single-center cohorts—particularly in middle-income countries—are limited. This study aimed to evaluate the prognostic value of ODx-RS and its association with treatment selection and progression-free survival (PFS) in a Turkish cohort. Methods: We retrospectively reviewed 64 female patients diagnosed with pT1–2, pN0–1mic, M0 HR+/HER2− breast cancer who underwent ODx-RS testing at Memorial Antalya Hospital between 2015–2024. Patients were stratified into low (<18) and intermediate/high (≥18) genomic risk groups. Treatment allocation to endocrine therapy (ET) alone or ET plus chemotherapy (ET+CT) followed multidisciplinary tumor board recommendations. Clinicopathological variables and ODx-RS were compared between groups. PFS was estimated using Kaplan–Meier analysis, and prognostic factors were assessed with Cox regression. Results: Median follow-up was 35.5 months. The median ODx-RS was 18, with 46.9% scoring <18 and 53.1% ≥18. Patients with ODx-RS ≥18 were significantly more likely to receive chemotherapy (95% vs. 34.1%, p<0.001). Grade 3 tumors were more prevalent in the ET+CT group (25% vs. 4.5%, p=0.004). Five-year PFS was higher in ET-only patients compared to ET+CT (94.3% vs. 62.4%, p=0.006) and in ODx-RS <18 vs. ≥18 (95.8% vs. 70.6%, p=0.016). In multivariate analysis, only stage II disease remained an independent predictor of progression (HR=8.85, 95% CI: 1.53–51.01, p=0.015). Conclusions: ODx-RS <18 was associated with excellent 5-year PFS, supporting the omission of chemotherapy in these patients without compromising outcomes. Tumor stage, rather than ODx-RS or menopausal status, was the strongest independent prognostic factor. These findings reinforce the clinical utility of ODx-RS in tailoring adjuvant therapy for early-stage HR+/HER2− breast cancer in real-world practice.

Özet

Background: The Oncotype DX 21-gene recurrence score (ODx-RS) assay guides adjuvant chemotherapy decisions in early-stage hormone receptor-positive (HR+), HER2-negative breast cancer. While validated in large clinical trials, real-world data from single-center cohorts—particularly in middle-income countries—are limited. This study aimed to evaluate the prognostic value of ODx-RS and its association with treatment selection and progression-free survival (PFS) in a Turkish cohort. Methods: We retrospectively reviewed 64 female patients diagnosed with pT1–2, pN0–1mic, M0 HR+/HER2− breast cancer who underwent ODx-RS testing at Memorial Antalya Hospital between 2015–2024. Patients were stratified into low (<18) and intermediate/high (≥18) genomic risk groups. Treatment allocation to endocrine therapy (ET) alone or ET plus chemotherapy (ET+CT) followed multidisciplinary tumor board recommendations. Clinicopathological variables and ODx-RS were compared between groups. PFS was estimated using Kaplan–Meier analysis, and prognostic factors were assessed with Cox regression. Results: Median follow-up was 35.5 months. The median ODx-RS was 18, with 46.9% scoring <18 and 53.1% ≥18. Patients with ODx-RS ≥18 were significantly more likely to receive chemotherapy (95% vs. 34.1%, p<0.001). Grade 3 tumors were more prevalent in the ET+CT group (25% vs. 4.5%, p=0.004). Five-year PFS was higher in ET-only patients compared to ET+CT (94.3% vs. 62.4%, p=0.006) and in ODx-RS <18 vs. ≥18 (95.8% vs. 70.6%, p=0.016). In multivariate analysis, only stage II disease remained an independent predictor of progression (HR=8.85, 95% CI: 1.53–51.01, p=0.015). Conclusions: ODx-RS <18 was associated with excellent 5-year PFS, supporting the omission of chemotherapy in these patients without compromising outcomes. Tumor stage, rather than ODx-RS or menopausal status, was the strongest independent prognostic factor. These findings reinforce the clinical utility of ODx-RS in tailoring adjuvant therapy for early-stage HR+/HER2− breast cancer in real-world practice.

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Cite This Article

Bayram, S., Tatlı, A. M., Özdoğan, M. (2026). Prognostic Value of Oncotype DX Recurrence Score in Early-Stage Hormone Receptor-Positive, HER2-Negative Breast Cancer: A Real-World Experience. Turkish Journal of Clinics and Laboratory, Cilt: 16 Sayı: 4, 555–563. https://doi.org/10.18663/tjcl.1770581

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