Caroline E. Lippe, Faith Seltun, Manpreet Sandhu, Katherine Barton, Yijin Wert, Berkay Demirors, Atilla Soran, Kit Lu
European Journal of Breast Health - 2026;22(1):87-91
Objective: The Oncotype Dx(R) assay is a validated tool for determining prognosis and predicting benefit from adjuvant systemic chemotherapy in patients with node-negative, early-stage hormone receptor (HR)-positive, human epidermal growth factor receptor-2 (HER-2)-negative breast cancer. However, genomic testing could incur additional costs, impacting both the patient and the health system. This study aims to explore a subset of patients with a Magee equation score <=18 who may safely forgo Oncotype Dx(R) testing. Materials and Methods: Single institution retrospective analysis of postmenopausal patients with de novo, unifocal breast carcinoma that is node negative, Nottingham grade 1, T1, HR positive (>1%), and HER-2 negative. Magee equation 2 (ME2) (https://path.upmc.edu/onlineTools/mageeequations.html) scores were calculated for each patient. The correlation coefficient between Oncotype Dx(R) and ME2 was determined. Results: Oncotype Dx(R) recurrence score, treatment, and outcomes were analyzed in 126 post-menopausal women diagnosed between 2015 and 2020. The mean tumor size was 1.09 cm, and the mean Oncotype DX(R) score was 12. The average ME2 score was 13.6. The correlation coefficient between Oncotype and ME2 score was statistically significant (r = 0.3442; p<0.0001). At a median follow-up of 5.03 years, there were no local or distant recurrences or breast cancer-related deaths reported in this patient cohort. Conclusion: This study suggests that omitting the Oncotype Dx(R) assay may be feasible in postmenopausal women with early breast cancer and an ME2 score <=18. Using comparable tools, such as ME2, may reduce financial toxicity in this population and overall costs to the system. Larger study recommended.
