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The impact of a genomic assay (Oncotype DX) on adjuvant treatment recommendations in early breast cancer

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Breast cancer is the most common malignancy in Australian women and most of these tumours are hormone receptor-positive (HR+).13 Adjuvant therapy for invasive breast cancer has been shown to improve survival.4 For early-stage, HR+, human epidermal growth factor receptor 2-negative (HER2) cancer, this therapy may consist of hormonal therapy (HT), or a combination of chemotherapy and hormonal therapy (CHT). It is accepted that the vast majority of patients with HR+, HER2 tumours should receive HT; however, the threshold for use of CHT is difficult to define because this group includes patients with a spectrum of recurrence risks.4,5 A large number of patients in whom the disease would not recur still receive CHT because accurate tools to help define the benefit of adjuvant chemotherapy have not been available.6,7

The 21-gene Oncotype DX breast cancer assay (Genomic Health) was developed…