Cancer Research and Treatment

Original Articles

A Nomogram for Predicting the Oncotype DX Recurrence Score in Women with T1-3N0-1miM0 Hormone Receptor‒Positive, Human Epidermal Growth Factor 2 (HER2)‒Negative Breast Cancer: Sae Byul Lee, Junetae Kim, Guiyun Sohn, Jisun Kim, Il Yong Chung, Hee Jeong Kim, Beom Seok Ko, Byung Ho Son, Sei-Hyun Ahn, Jong Won Lee, Kyung Hae Jung; Cancer Res Treat. 2019;51(3):1073-1085. Published online November 1, 2018; DOI: https://doi.org/10.4143/crt.2018.357

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Purpose
This preliminary study was conducted to evaluate the association between Oncotype DX (ODX) recurrence score and traditional prognostic factors. We also developed a nomogram to predict subgroups with low ODX recurrence scores (less than 25) and to avoid additional chemotherapy treatments for those patients.
Materials and Methods
Clinicopathological and immunohistochemical variables were retrospectively retrieved and analyzed from a series of 485 T1-3N0-1miM0 hormone receptor-positive, human epidermal growth factor 2‒negative breast cancer patients with available ODX test results at Asan Medical Center from 2010 to 2016. One hundred twenty-seven patients (26%) had positive axillary lymph node micrometastases, and 408 (84%) had ODX recurrence scores of ≤25. Logistic regression was performed to build a nomogram for predicting a low-risk subgroup of the ODX assay.
Results
Multivariate analysis revealed that estrogen receptor (ER) score, progesterone receptor (PR) score, histologic grade, lymphovascular invasion (LVI), and Ki-67 had a statistically significant association with the low-risk subgroup. With these variables, we developed a nomogram to predict the low-risk subgroup with ODX recurrence scores of ≤25. The area under the receiver operating characteristic curve was 0.90 (95% confidence interval [CI], 0.85 to 0.96). When applied to the validation group the nomogram was accurate with an area under the curve = 0.88 (95% CI, 0.83 to 0.95).
Conclusion
The low ODX recurrence score subgroup can be predicted by a nomogram incorporating five traditional prognostic factors: ER, PR, histologic grade, LVI, and Ki-67. Our nomogram, which predicts a low-risk ODX recurrence score, will be a useful tool to help select patients who may or may not need additional ODX testing.

Citations

Citations to this article as recorded by

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Mao Ding, Hong Zhang, Qian Wu, Hongyu Xiang, Yuanjia Cheng, Ling Xu
Clinical Breast Cancer.2026; 26(10): 162. CrossRef
A Novel Nomogram for Estimating a High-Risk Result in the EndoPredict® Test for Estrogen Receptor-Positive/Human Epidermal Growth Factor Receptor 2 (HER2)-Negative Breast Carcinoma
Víctor Macarrón, Itsaso Losantos-García, Alberto Peláez-García, Laura Yébenes, Alberto Berjón, Laura Frías, Covadonga Martí, Pilar Zamora, José Ignacio Sánchez-Méndez, David Hardisson
Cancers.2025; 17(2): 273. CrossRef
Nomogram Development for Assessing Oncotype DX Recurrence Scores in Breast Cancer: A Chinese Population Study
Jiayin Song, Lin Yang, Zhengqi Feng, Liyu Jiang
Cancer Medicine.2025;[Epub] CrossRef
Factors Affecting the Survival of Metastatic Breast Cancer Patients Treated with CDK 4/6 Inhibitors
Zehra Sucuoğlu İşleyen, Harun Muğlu, Zeynep Alaca Topçu, Mehmet Beşiroğlu, Ayşe İrem Yasin, Atakan Topçu, Melih Şimşek, Mesut Şeker, Hacı Mehmet Türk
Medicina.2025; 61(7): 1279. CrossRef
Background parenchymal enhancement as a predictor of invasive disease-free survival in hormone receptor-positive, HER2-negative breast cancer
Su Min Cho, Hye Joung Eom, Hee Jeong Kim, Woo Jung Choi, Eun Young Chae, Hee Jung Shin, Joo Hee Cha, Hak Hee Kim
European Journal of Radiology.2025; 191: 112340. CrossRef
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Wei Wang, Wenqian Lei, Ziru Fang, Ruiyuan Jiang, Xiaojia Wang
BMC Cancer.2024;[Epub] CrossRef
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Asim Dhungana, Augustin Vannier, Fangyuan Zhao, Jincong Q. Freeman, Poornima Saha, Megan Sullivan, Katharine Yao, Elbio M. Flores, Olufunmilayo I. Olopade, Alexander T. Pearson, Dezheng Huo, Frederick M. Howard
npj Breast Cancer.2024;[Epub] CrossRef
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Ji Min Kim, Eun Yoon Cho
Journal of Breast Cancer.2024; 27(3): 201. CrossRef
Development of a nomogram to predict recurrence scores obtained using Oncotype DX in Japanese patients with breast cancer
Akio Shibata, Nobuko Tamura, Keiichi Kinowaki, Aya Nishikawa, Kiyo Tanaka, Yoko Kobayashi, Takuya Ogura, Yuko Tanabe, Hidetaka Kawabata
Breast Cancer.2024; 31(6): 1018. CrossRef
Shear-wave elastography-based nomograms predicting 21-gene recurrence score for adjuvant chemotherapy decisions in patients with breast cancer
Ji Hyun Youk, Eun Ju Son, Joon Jeong, Hye Mi Gweon, Na Lae Eun, Jeong-Ah Kim
European Journal of Radiology.2023; 158: 110638. CrossRef
Prediction of Oncotype DX Recurrence Score Using Clinicopathological Variables in Estrogen Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer
Min Chong Kim, Sun Young Kwon, Jung Eun Choi, Su Hwan Kang, Young Kyung Bae
Journal of Breast Cancer.2023; 26(2): 105. CrossRef
Clinicopathological Factors Associated with Oncotype DX Risk Group in Patients with ER+/HER2- Breast Cancer
Ran Song, Dong-Eun Lee, Eun-Gyeong Lee, Seeyoun Lee, Han-Sung Kang, Jai Hong Han, Keun Seok Lee, Sung Hoon Sim, Heejung Chae, Youngmee Kwon, Jaeyeon Woo, So-Youn Jung
Cancers.2023; 15(18): 4451. CrossRef
A simplified risk scoring system for predicting high-risk groups in gene expression tests for patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-positive breast cancer
Kwang Hyun Yoon, Suk Jun Lee, Yujin Kim, Jee Hyun Ahn, Jee Ye Kim, Hyung Seok Park, Seung Il Kim, Seho Park
Annals of Surgical Treatment and Research.2023; 105(6): 360. CrossRef
Deep Learning-Based Pathology Image Analysis Enhances Magee Feature Correlation With Oncotype DX Breast Recurrence Score
Hongxiao Li, Jigang Wang, Zaibo Li, Melad Dababneh, Fusheng Wang, Peng Zhao, Geoffrey H. Smith, George Teodoro, Meijie Li, Jun Kong, Xiaoxian Li
Frontiers in Medicine.2022;[Epub] CrossRef
A Novel Surrogate Nomogram Capable of Predicting OncotypeDX Recurrence Score©
Matthew G. Davey, Amirhossein Jalali, Éanna J. Ryan, Ray P. McLaughlin, Karl J. Sweeney, Michael K. Barry, Carmel M. Malone, Maccon M. Keane, Aoife J. Lowery, Nicola Miller, Michael J. Kerin
Journal of Personalized Medicine.2022; 12(7): 1117. CrossRef
Use of a supervised machine learning model to predict Oncotype DX risk category in node-positive patients older than 50 years of age
Austin D. Williams, Kate R. Pawloski, Hannah Y. Wen, Varadan Sevilimedu, Donna Thompson, Monica Morrow, Mahmoud El-Tamer
Breast Cancer Research and Treatment.2022; 196(3): 565. CrossRef
The Role of Oncotype DX® Recurrence Score in Predicting Axillary Response After Neoadjuvant Chemotherapy in Breast Cancer
Jaime A. Pardo, Betty Fan, Alessandra Mele, Stephanie Serres, Monica G. Valero, Isha Emhoff, Amulya Alapati, Ted A. James
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Jing Yu, Jiayi Wu, Ou Huang, Jianrong He, Li Zhu, Weiguo Chen, Yafen Li, Xiaosong Chen, Kunwei Shen
Journal of Translational Medicine.2021;[Epub] CrossRef
Clinicopathological correlates, oncological impact, and validation of Oncotype DX™ in a European Tertiary Referral Centre
Matthew G. Davey, Éanna J. Ryan, Sami Abd Elwahab, Jessie A. Elliott, Peter F. McAnena, Karl J. Sweeney, Carmel M. Malone, Ray McLaughlin, Michael K. Barry, Maccon M. Keane, Aoife J. Lowery, Michael J. Kerin
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Dynamic contrast enhanced-MRI and diffusion-weighted image as predictors of lymphovascular invasion in node-negative invasive breast cancer
Bo Bae Choi
World Journal of Surgical Oncology.2021;[Epub] CrossRef
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Minji Koh, Jinhong Jung, Su Ssan Kim, Seung Do Ahn, Eun Kyung Choi, Il Yong Chung, Jong Won Lee, Sung-Bae Kim, Jae Ho Jeong
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Scientific Reports.2021;[Epub] CrossRef
Development of a Nomogram to Predict the Recurrence Score of 21-Gene Prediction Assay in Hormone Receptor–Positive Early Breast Cancer
Shin Hye Yoo, Tae-Yong Kim, Miso Kim, Kyung-Hun Lee, Eunshin Lee, Han-Byoel Lee, Hyeong-Gon Moon, Wonshik Han, Dong-Young Noh, Sae-Won Han, Tae-You Kim, Seock-Ah Im
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Clinical Breast Cancer.2020; 20(5): e600. CrossRef

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The Clinical Impact of 21-Gene Recurrence Score on Treatment Decisions for Patients with Hormone Receptor-Positive Early Breast Cancer in Korea: Moo Hyun Lee, Wonshik Han, Jeong Eon Lee, Ku Sang Kim, Heeseung Park, Jongjin Kim, Soo Youn Bae, Hyun Joo Shin, Jong Won Lee, Eun Sook Lee; Cancer Res Treat. 2015;47(2):208-214. Published online September 11, 2014; DOI: https://doi.org/10.4143/crt.2013.223

Abstract PDF PubReader ePub

Purpose
The 21-gene (Oncotype DX) recurrence score (RS) assay is useful in predicting the benefits of adjuvant chemotherapy for early breast cancer patients and is widely used in Western countries. However, to date, it has not gained much popularity in East Asia. We analyzed the results from five institutions’ experience from using the 21-gene assay and examined the impact of assay results on decision making of chemotherapy in Korean breast cancer patients and the associations between RS and clinicopathologic characteristics.
Materials and Methods
The 21-gene assay was performed on 212 patients with estrogen receptor-positive early breast cancer in five institutions. Each center made systemic treatment decisions both before and after the knowledge of assay results.
Results
Among the 212 patients, 132 (62.3%) had a low RS of < 18, 60 (28.3%) had an intermediate RS of 18-30, and 20 (9.4%) had a high RS of ≥ 31. Histologic grade, presence of micrometastases, Ki-67, and presence of lymphatic invasion were statistically associated with the RS results. Treatment decisions were changed in 115 of 212 patients (54.2%) in 109 of 212 (51.4%) from chemotherapy plus hormone therapy to hormone therapy, and in six of 212 (2.8%) from hormone therapy to chemotherapy plus hormone therapy.
Conclusion
The 21-gene breast cancer assay proved to have a significant impact on treatment decision- making. The test reduces chemotherapy use in more than 50% of Korean estrogen receptor-positive, early breast cancer patients.

Citations

Citations to this article as recorded by

The Rochester Modified Magee Algorithm (RoMMa): An Outcomes Based Strategy for Clinical Risk-Assessment and Risk-Stratification in ER Positive, HER2 Negative Breast Cancer Patients Being Considered for Oncotype DX® Testing
Bradley M. Turner, Brian S. Finkelman, David G. Hicks, Numbere Numbereye, Ioana Moisini, Ajay Dhakal, Kristin Skinner, Mary Ann G. Sanders, Xi Wang, Michelle Shayne, Linda Schiffhauer, Hani Katerji, Huina Zhang
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Journal of Personalized Medicine.2021; 11(9): 858. CrossRef
Biomarker and multigene assay testing in ER positive, HER-2 negative breast carcinomas: An international guidelines-based approach
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Human Pathology Reports.2021; 26: 300574. CrossRef
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Shin Hye Yoo, Tae-Yong Kim, Miso Kim, Kyung-Hun Lee, Eunshin Lee, Han-Byoel Lee, Hyeong-Gon Moon, Wonshik Han, Dong-Young Noh, Sae-Won Han, Tae-You Kim, Seock-Ah Im
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