ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2016
21-Gene Recurrence Score Assay As a Predictor of Adjuvant Chemotherapy Administration for Early-Stage Breast Cancer: An Analysis of Use, Therapeutic Implications, and Disparity Profile.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are There Socio-Demographic Inequalities in the Utilisation of Tumour and ctDNA Somatic Mutation Testing in Solid Tumours? A Systematic Review.Cancer medicine · 2026Pooled it
- Prognostic consistency of oncotype DX® molecular assay across racial groups in early-stage hormone receptor-positive breast cancer.NPJ breast cancer · 2026Article
- Genetic Ancestry and 21-Gene Oncotype DX Breast Cancer Recurrence Scores.Annals of surgical oncology · 2025Article
- Inference on moderation effect with third-variable effect analysis - application to explore the trend of racial disparity in oncotype dx test for breast cancer treatment.Journal of applied statistics · 2022Article
- Grading of invasive breast carcinoma: the way forward.Virchows Archiv : an international journal of pathology · 2022Review
- Hospital Rurality and Gene Expression Profiling for Early-Stage Breast Cancer among Iowa Residents (2010-2018).The breast journal · 2022Article
- Adherence to Endocrine Therapy and Racial Outcome Disparities in Breast Cancer.The oncologist · 2021Review
- Lymphovascular invasion, race, and the 21-gene recurrence score in early estrogen receptor-positive breast cancer.NPJ breast cancer · 2021Article
- Racial and ethnic disparities in 21-gene recurrence scores, chemotherapy, and survival among women with hormone receptor-positive, node-negative breast cancer.Breast cancer research and treatment · 2020Article
- Patient and physician factors associated with Oncotype DX and adjuvant chemotherapy utilization for breast cancer patients in New Hampshire, 2010-2016.BMC cancer · 2020Article
- Clinicopathological characteristics, adjuvant chemotherapy decision and disease outcome in patients with breast cancer with a 21-gene recurrence score of 26-30.Oncology letters · 2020Article
- Trend and survival benefit of Oncotype DX use among female hormone receptor-positive breast cancer patients in 17 SEER registries, 2004-2015.Breast cancer research and treatment · 2020Article
- MAGI1, a New Potential Tumor Suppressor Gene in Estrogen Receptor Positive Breast Cancer.Cancers · 2020Article
- Do 21-Gene Recurrence Score Influence Chemotherapy Decisions in T1bN0 Breast Cancer Patients?Frontiers in oncology · 2020Article
- Adjuvant chemotherapy and survival among patients 70 years of age and younger with node-negative breast cancer and the 21-gene recurrence score of 26-30.Breast cancer research : BCR · 2019Article
- Blending Insights from Implementation Science and the Social Sciences to Mitigate Inequities in Screening for Hereditary Cancer Syndromes.International journal of environmental research and public health · 2019Article
- Race and risk of subsequent aggressive breast cancer following ductal carcinoma in situ.Cancer · 2019Article
- Article
- Hypoxia gene expression signatures as predictive biomarkers for personalising radiotherapy.The British journal of radiology · 2019Review
- Oncotype DX recurrence score implications for disparities in chemotherapy and breast cancer mortality in Georgia.NPJ breast cancer · 2019Article
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7 authors.
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Abstract
purposeThe 21-gene Recurrence Score (RS) assay is used to predict disease recurrence and benefit of chemotherapy in estrogen receptor-positive, lymph node-negative early-stage breast cancer (EBC). Our study is the first analysis of trends and differences in the use of the RS assay and its impact on recommending chemotherapy in a population-based data set.
methodsPatients with EBC diagnosed from 2004 to 2012 and included in the National Cancer Data Base were analyzed. Multivariate logistic regression analysis was used to estimate the covariates associated with use of the test and its impact on chemotherapy decisions.
resultsThe RS assay was ordered for 54.0% of the 143,032 identified patients. Of all the variables, RS assay had the strongest association with recommendation for chemotherapy, with an adjusted odds ratio (AOR) of 83 for high assay scores. When indicated, test use was significantly associated with younger age, white race, academic centers, private insurance, and pT2/pN0(i+) grade 2 to 3 disease. Black patients (AOR, 1.31; 95% CI, 1.20 to 1.43) and those treated in community facilities (AOR, 1.49; 95% CI, 1.35 to 1.63) were more likely to be tested outside the National Comprehensive Cancer Network guidelines. Black patients (AOR, 1.51; 95% CI, 1.31 to 1.69) and those with high tumor grade (AOR, 30.76; 95% CI, 26.48 to 35.73) had significantly higher assay scores. Younger black patients (AOR, 1.33; 95% CI, 1.16 to 1.54) were more likely to receive chemotherapy despite low assay scores.
conclusionThe RS assay significantly influences clinicians' recommendations for chemotherapy in patients with EBC. Black patients tended to have higher assay scores, which may reflect use patterns or less favorable tumor biology for estrogen receptor-positive disease. There are significant differences in use and clinical implications of the test on the basis of race, insurance, and type of facility.
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