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How Does Invasive Breast Cancer Oncotype Dx Recurrence Score on Core Needle Biopsies Influence Neoadjuvant Treatment

Gahie Nam¹, Kamaljeet Singh², Mary L Lopresti³

¹Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Warren Alpert Medical School of Brown University, Providence, RI, USA.

Technology in Cancer Research & Treatment

|October 26, 2021

Summary

This summary is machine-generated.

Oncotype Dx (ODx) genomic testing on core needle biopsies (CNB) effectively guides neoadjuvant treatment decisions for early breast cancer, especially in complex cases. This approach ensures timely and personalized therapy administration.

Keywords:

Oncotype Dx core needle biopsy neoadjuvant neoadjuvant chemotherapy neoadjuvant hormonal therapy recurrence score

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Area of Science:

Oncology
Genomics
Breast Cancer Research

Background:

Oncotype Dx (ODx) is a genomic assay used to assess recurrence risk and chemotherapy benefit in early-stage breast cancer.
Current ODx data predominantly originates from excisional biopsy specimens.

Purpose of the Study:

To evaluate the utility of Oncotype Dx (ODx) testing on core needle biopsies (CNB).
To determine the impact of ODx results from CNB on neoadjuvant treatment decisions, particularly in complex clinical scenarios.

Main Methods:

Retrospective review of consecutive ODx results on breast CNBs with invasive carcinoma (2012-2020) from three tertiary care hospitals.
Analysis of clinical indications for ODx on CNB via electronic medical records.
Recording of clinicopathologic features, treatment modalities, and follow-up data.

Main Results:

Three primary indications for ODx on CNB were identified in 85 ER+ invasive breast carcinomas.
ODx guided decisions between neoadjuvant therapy and primary surgery, and between neoadjuvant chemotherapy (NAC) and neoadjuvant endocrine therapy (NET).
Low recurrence scores (RS <18) favored primary surgery or NET, while intermediate/high scores (RS >18) favored NET over NAC.

Conclusions:

ODx results from CNB are valuable for guiding neoadjuvant treatment decisions in early breast cancer, complementing other clinical factors.
The use of ODx on CNB is particularly relevant during the COVID-19 pandemic for timely and effective treatment delivery.