21-Gene Recurrence Score (Oncotype DX)

  • The 21-gene recurrence score estimates the likelihood of distant recurrence:
    • In women with ER+ breast cancer with up to 3 lymph nodes positive
  • It also predicts who is more likely to benefit from adjuvant chemotherapy:
  • Patients with more than 3 lymph nodes:
    • Usually receive adjuvant chemotherapy and 21-gene signature assay is not routinely ordered


1. Dowsett M, Cuzick J, Wale C, Forbes J, Mallon EA, Salter J, et al. Prediction of risk of distant recurrence using the 21-gene recurrence score in node-negative and node-positive postmenopausal patients with breast cancer treated with anastrozole or tamoxifen: a TransATAC study. J Clin Oncol. 2010;29(11):1829-1834.

2. Roberts MC, Miller DP, Shak S, Petkov VI. Breast cancer-specific survival in patients with lymph node-positive hormone receptor-positive invasive breast cancer and Oncotype DX Recurrence Score results in the SEER database. Breast Cancer Res Treat.2017;163(2):303-310.

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