ABSTRACT
Introduction: Oncotype DX, a 21 gene assay has prognostic and chemotherapy predictive value. During COVID pandemic, guidance issued extended use of genomic testing to avoid chemotherapy to node positive patients. We aimed to identify impact of Oncotype DX testing in pre-operative setting of early breast cancer. Method(s): We retrospectively reviewed those patients where MDT recommended upfront Oncotype DX testing from 1st March 2020 till Sept 2022. Result(s): 59 patients were identified. The mean age was 55.7 +/- 11.4 years. Two-thirds were postmenopausal. Four-fifth had symptomatic presentation. the mean tumour size was 28.8 +/- 8.7 mm. Invasive ductal carcinoma was seen in 81% (N=48). Progesterone receptor positivity was seen in 93% (n=55). Node positivity was seen in 44% (n=26) while nodes were negative in 56% (n=33). Overall, low, intermediate and high score was seen in 47% (n=28), 8% (n=5) and 45% (n=26) respectively. In node negative patients, low, intermediate, and high score was seen in 45% (n=15), 10% (n=3) and 45% (n=15) respectively. Chemotherapy was avoided in 55% patients. In node positive patients, low, intermediate, and high score was seen in 50% (n=15), 8% (n=2) and 42% (n=11) respectively. Overall, chemotherapy was avoided in 23% patients with node positive disease. Conclusion(s): Upfront Oncotype DX testing can be used in node negative breast cancer patients. However, it should be used very cautiously in node positive women.Copyright © 2023