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High RS Chemotherapy — SCE Medical Oncology MCQ

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EasyBreast CancerHigh RS ChemotherapySCE Medical Oncology

A 58-year-old woman with ER+/HER2- breast cancer has a 21-gene recurrence score (Oncotype DX) of 31. She is 58 and node-negative. What adjuvant systemic therapy is recommended?

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Correct answer: C — Adjuvant chemotherapy followed by endocrine therapy — RS ≥26 indicates chemotherapy benefit regardless of age or menopausal status in node-negative HR+/HER2- breast cancer

TAILORx: RS ≥26 = clear chemotherapy benefit for all patients regardless of age. Standard: anthracycline-taxane or TC chemotherapy → 5-10 years endocrine therapy. RS guides the chemo decision, not the endocrine decision (all ER+ patients receive ET).

Reference: NICE DG34; TAILORx; ESMO 2024