Do you recommend sending Oncotype for bilateral synchronous primary ER+ breast cancers?  

Yes I would recommend OncoType Dx for bilateral synchronous primary ER+ breast cancers. A couple of studies, although with a small sample size, have looked at this. The first one by Karsten et al (Ann Surg Oncol. 2016) showed only a 67% concordance rate for recurrence score by Oncotype Dx for synchr...