Evidence map›Paper›PMID 40836145›Full record

ArticleAnnals of surgical oncology2025

Biology is Queen: The Oncotype DX 21-Gene Recurrence Score Has Stronger Prognostic Ability than Lymph Node Burden for Patients with Breast Cancer.

Chelsea Marin, Myla Strawderman, Derick Peterson, Zijing Cheng, Yue Li, Jessica C Gooch, Ajay Dhakal, Kimberly R Gergelis, Bradley Turner, Edward B Brown and 2 more

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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

12 authors.

Chelsea MarinDepartment of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Myla StrawdermanDepartment of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA.
Derick PetersonDepartment of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA.
Zijing ChengDivision of Health Policy and Outcomes, Department of Public Health Sciences, University of Rochester, Rochester, NY, USA.
Yue LiDivision of Health Policy and Outcomes, Department of Public Health Sciences, University of Rochester, Rochester, NY, USA.
Jessica C GoochDivision of Surgical Oncology, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Ajay DhakalWilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
Kimberly R GergelisDepartment of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Bradley TurnerWilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
Edward B BrownWilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
Ruth O'ReganWilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.
Anna WeissDivision of Surgical Oncology, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA. Anna_Weiss@urmc.rochester.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBreast cancer treatment is increasingly based on biologic instead of anatomic factors; however, some decisions still rely on anatomic information obtained at axillary lymph node dissection (ALND), such as chemotherapy administration. The goal of this study was to determine if the Oncotype DX 21-gene recurrence score (RS) or the number of positive lymph nodes (+LNs) were stronger predictors of overall survival (OS), to potentially support ALND omission.

methodsThe National Cancer Database was queried for patients aged ≥18 years with non-metastatic, hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) breast cancer with available RS treated with upfront surgery from 2018 to 2019. We summarized clinical characteristics, estimated OS via Kaplan-Meier curves, and performed regression analyses to determine the association of RS and +LNs with OS.

resultsAmong 71,235 patients analyzed, OS was significantly worse for patients with RS >25 compared with ≤25 (p<0.0001) and for patients with increasing numbers of +LNs (p < 0.0001). Within most LN categories (0, 1-3, 4-9, or ≥10 +LNs), patients with RS >25 had worse OS than patients with RS ≤25 (p < 0.0001, p < 0.0001, p = 0.0024, and p = 0.1767, respectively). On regression analysis, RS >25 and +LNs significantly predicted OS. RS >25 was a stronger predictor of OS than number of +LNs, but the model combining RS and number of +LNs was stronger than either factor alone.

conclusionsThis study of patients with HR+/HER2- breast cancer suggests RS is a stronger predictor of death compared with LN status. This supports the idea that biologic factors may be more impactful than anatomic factors but does not currently obviate the need for ALND.

Indexed as

Biomarkers, TumorBreast NeoplasmsLymph NodesNeoplasm Recurrence, LocalAdultAgedErb-b2 Receptor Tyrosine KinasesFemaleFollow-Up StudiesGene Expression ProfilingHumansLymphatic MetastasisLymph Node ExcisionMiddle AgedPrognosisReceptors, EstrogenBiomarkers, TumorERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, Estrogen

Identifiers

PMID40836145

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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.