Evidence map›Paper›PMID 41691575›Full record

ArticleBreast cancer (Tokyo, Japan)2026

Cost-effectiveness analysis of the Oncotype DX Breast Recurrence Score

Kei Koizumi, Ataru Igarashi, Mark Gouldson, Sandeep Bilthare, Sebastien Eymere, Gebra Cuyún-Carter, Steve Millen, Mariko Nomoto, Yoshie Onishi, Aki Kudo and 4 more

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Article in Breast cancer (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Kei KoizumiDepartment of Surgery 1, Division of Breast Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Ataru IgarashiGraduate School of Pharmaceutical Sciences, Health Policy and Public Health, The University of Tokyo, Tokyo, Japan.
Mark GouldsonPutnam, London, UK. mark.gouldson@putassoc.com.ORCID http://orcid.org/0009-0006-7259-0881
Sandeep BiltharePutnam, London, UK.ORCID http://orcid.org/0009-0003-0563-3675
Sebastien EymerePutnam, London, UK.ORCID http://orcid.org/0000-0001-8074-5480
Gebra Cuyún-CarterExact Sciences, Madison, WI, USA.ORCID http://orcid.org/0000-0002-6549-0069
Steve MillenExact Sciences, Madison, WI, USA.ORCID http://orcid.org/0009-0007-9386-8552
Mariko NomotoPutnam, London, UK.
Yoshie OnishiPutnam, London, UK.
Aki KudoExact Sciences, Madison, WI, USA.
Pieter DrostExact Sciences, Madison, WI, USA.
Naoko SugiyamaExact Sciences, Madison, WI, USA.
Tom Kanazawa TangExact Sciences, Madison, WI, USA.
Naoki NiikuraDepartment of Breast Oncology, Tokai University School of Medicine, Isehara, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Oncotype DX Breast Recurrence Score® test is prognostic for distant recurrence in hormone receptor positive (HR+), human epidermal growth factor 2 negative (HER2-) early-stage breast cancer. It is the only multigene assay able to predict chemotherapy benefit, validated by evidence from randomized controlled trials. Using a Japanese public healthcare payer perspective, a cost-effectiveness analysis was conducted comparing the Oncotype DX® test to clinico-pathological risk assessment in women with node-negative (N0), HR+/HER2- early breast cancer.

methodsA decision-tree stratified patients according to their Recurrence Score® (RS®) result and adjuvant chemotherapy allocation. A Markov model was used to capture lifetime costs and outcomes of the chosen treatment. Distributions of clinical risk in N0 patients were derived from the TAILORx trial. Distant recurrence probability conditional on RS result was calculated using TAILORx and NSABP-20 studies. Endocrine and chemoendocrine therapy selection was informed by a Clinical Expert Survey and the literature. Drugs and medical device costs were obtained from the Ministry of Health, Labour and Welfare.

resultsThe Oncotype DX test was dominant (i.e. cost-saving and more effective) as it generated more quality-adjusted life-years (QALYs) (0.207) at a lower cost (-¥649,596) compared to clinico-pathological risk assessment in the overall population. Cost savings were primarily driven by a lower incidence of distant recurrence (-¥1,007,177). The Oncotype DX test was dominant in all subgroups except for one, which was cost-effective.

conclusionsUse of the Oncotype DX test to guide treatment decisions improves patient outcomes while reducing healthcare costs for N0 HR+/HER2- early-stage breast cancer in Japan.

Indexed as

Breast NeoplasmsCost-Benefit AnalysisCost-Effectiveness AnalysisGene Expression ProfilingNeoplasm Recurrence, LocalBiomarkers, TumorChemotherapy, AdjuvantDecision TreesErb-b2 Receptor Tyrosine KinasesFemaleHumansJapanMarkov ChainsMiddle AgedNeoplasm StagingPrognosisBiomarkers, TumorERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, ProgesteroneBreast cancerChemotherapyCost-effectivenessThe Oncotype DX® testTumor profiling test

Identifiers

PMID41691575
PMCPMC12960466

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Registered trials

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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.