Menopausal status does not predict Oncotype DX recurrence score.

Area of Science:

• Oncology
• Genomics
• Breast Cancer Research

Background:

• Adjuvant treatment for early-stage, estrogen receptor (ER)-positive invasive breast cancer often relies on menopausal status.
• The 21-gene assay Oncotype DX (ODX) predicts distant recurrence but is underutilized in premenopausal patients.
• This study evaluates the relationship between menopausal status and ODX Recurrence Score (RS).

Purpose of the Study:

• To investigate the association between menopausal status and the Recurrence Score (RS) in early-stage, ER-positive invasive breast cancer.
• To determine if menopausal status influences the utility of the Oncotype DX (ODX) assay.
• To inform clinical decision-making regarding ODX testing in premenopausal women.

Main Methods:

• Retrospective review of 575 invasive breast cancer patients with known RS.
• Classification of perimenopausal women as premenopausal for analysis.
• Statistical comparison of menopausal status and RS using general linear regression and Wilcoxon rank-sum test.

Main Results:

• Median RS was 16 for both premenopausal and postmenopausal women.
• Menopausal status was not a significant predictor of RS (P=0.6780).
• Premenopausal women had higher local-regional recurrence rates but similar distant recurrence and overall survival compared to postmenopausal women.

Conclusions:

• Menopausal status has limited predictive value for distant recurrence in ER-positive, early-stage breast cancer.
• The Oncotype DX (ODX) assay's predictive value is not significantly altered by menopausal status.
• Clinicians should consider ODX testing for ER-positive, early-stage breast cancer irrespective of menopausal status.