How would you approach a patient with localized breast cancer who had a low Oncotype Dx recurrence score but a 20% risk of distant recurrence (without chemotherapy)?

The question asks how to treat a patient with a low Oncotype Dx score, but an estimated risk of recurrence of 20% without chemotherapy.

I am presuming the estimated recurrence risk is based on clinical parameters, such as tumor size and grade, independently from the molecular profiling data. If this is the case, the question could also be framed as ‘what do you do when your clinical assessment and molecular profiling data are discordant?’

There is not a simple answer to this question, but the premise of molecular profiling is that it provides prognostic, and potentially predictive information independent of clinical risk factors.

The Tailorx trial addressed the utility of the 21 gene recurrence score prospectively in women with ER+, node ne...