Evidence map›Paper›PMID 39365509›Full record

Observational studyBreast cancer research and treatment2025

Irish national real-world analysis of the clinical and economic impact of 21-gene oncotype DX® testing in early-stage, 1-3 lymph node-positive, oestrogen receptor-positive, HER2-negative, breast cancer.

I M Browne, R A McLaughlin, C S Weadick, S O'Sullivan, L M McSorley, D K Hadi, S J Millen, M J Higgins, J P Crown, R S Prichard and 13 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Budget impact analysis of Oncotype DXThe European journal of health economics : HEPAC : health economics in prevention and care · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

I M BrowneDepartment of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland. ibrowne@tcd.ie.
R A McLaughlinDepartment of Medical Oncology, Beaumont Hospital, Beaumont, Dublin, Ireland.
C S WeadickDepartment of Medical Oncology, Cork University Hospital, Cork, Ireland.
S O'SullivanDepartment of Medical Oncology, Mater Misericordiae University Hospital, Dublin 7, Ireland.
L M McSorleyDepartment of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland.
D K HadiDepartment of Medical Oncology, St James's Hospital, Dublin 8, Ireland.
S J MillenExact Sciences UK Ltd, London, UK.
M J HigginsDepartment of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland.
J P CrownDepartment of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland.
R S PrichardDepartment of Surgery, St. Vincent's University Hospital, Dublin, Ireland.
D P McCartanDepartment of Surgery, St. Vincent's University Hospital, Dublin, Ireland.
A Dk HillDepartment of Surgery, Royal College of Surgeons, Dublin, Ireland.
R M ConnollyCancer Research @ UCC, University College Cork, Cork, Ireland.
S A NoonanCancer Research @ UCC, University College Cork, Cork, Ireland.
D O'MahonyDepartment of Medical Oncology, Bon Secours Hospital, Cork, Ireland.
C MurrayDepartment of Pathology, St. Vincent's University Hospital, Dublin 4, Ireland.
C O'Hanlon-BrownDepartment of Medical Oncology, St James's Hospital, Dublin 8, Ireland.
B T HennessyDepartment of Medical Oncology, Beaumont Hospital, Beaumont, Dublin, Ireland.
C M QuinnDepartment of Pathology, St. Vincent's University Hospital, Dublin 4, Ireland.
C M KellyDepartment of Medical Oncology, Mater Misericordiae University Hospital, Dublin 7, Ireland.
S O'ReillyCancer Research @ UCC, University College Cork, Cork, Ireland.
P G MorrisDepartment of Medical Oncology, Beaumont Hospital, Beaumont, Dublin, Ireland.
J M WalsheDepartment of Medical Oncology, St Vincent's University Hospital, Dublin 4, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe treatment landscape of Oestrogen receptor-positive (ER-positive) breast cancer is evolving, with declining chemotherapy use as a result of Oncotype DX Breast Recurrence Score® testing. Results from the SWOG S1007 RxPONDER trial suggest that adjuvant chemotherapy may benefit some premenopausal women with ER-positive, HER2-negative disease with 1-3 positive lymph nodes (N1), and a Recurrence Score® (RS) of ≤ 25. Postmenopausal women with similar characteristics did not benefit from adjuvant chemotherapy. We examine the clinical and economic impact of Oncotype DX® testing on treatment decisions in patients with N1 disease in Ireland using real world data.

methodsFrom March 2011 to October 2022, a retrospective, cross-sectional observational study was performed of patients with ER-positive, HER2-negative N1 breast cancer, who had Oncotype DX testing across 5 of Ireland's largest cancer centres. Patients were classified into low risk (RS 0-13), intermediate risk (RS 14-25) and high risk (RS > 25). Data were collected via electronic patient records. Information regarding costing was provided primarily by pre-published sources.

resultsA total of 828 N1 patients were included in this study. Post Oncotype DX testing, 480 patients (58%) were spared chemotherapy. Of the patients who had a change in chemotherapy recommendation based on Oncotype DX testing, 271 (56%), 205 (43%), 4 (1%) had a RS result of 0-13, 14-25 and > 25 respectively. Use of Oncotype DX testing was associated with a 58% reduction in chemotherapy administration overall. This resulted in estimated savings of over €6 million in treatment costs. Deducting the assay cost, estimated net savings of over €3.3 million were achieved. Changes in the ordering demographics of Oncotype DX tests were identified after RxPONDER data were presented, with increased testing in women ≥ 50 years and a reduction in proportion of tests ordered for women < 50 years.

conclusionBetween 2011 and 2022, assay use resulted in a 58% reduction in chemotherapy administration and net savings of over €3.3 million.

Indexed as

Biomarkers, TumorBreast NeoplasmsAdultAgedAged, 80 and overChemotherapy, AdjuvantCost-Benefit AnalysisCross-Sectional StudiesErb-b2 Receptor Tyrosine KinasesFemaleGene Expression ProfilingHumansIrelandLymphatic MetastasisLymph NodesMiddle AgedBiomarkers, TumorERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenBreast cancerDecision impactEconomic impactNode-positiveOncotype DX recurrence score

Identifiers

PMID39365509
PMCPMC11785674

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.