How would you approach adjuvant systemic therapy for a pT3N0(i+) HR+/HER2 negative breast cancer with an intermediate oncotype in a post-menopausal woman?

This is a great question that I ponder a lot. I've asked countless colleagues informally "what's the largest tumor you'll trust oncotype on"? The only true “prediction” data we have comes from the original B-20 trial, which included T3 tumors. Although the publication only breaks out tumor size as >...

There is limited data on T3 patients mostly from retrospective registry data. Risk does increase as T size increases. The most conservative approach is to offer chemotherapy like TCx4 to all of them. However, there is some interesting data from a SEER study (including about 1000 T3 cases, 4.2% of al...

Consider MammaPrint. MINDACT had larger tumors, and tumors with high clinical risk and low genomic risk on 70 gene signature is less likely to derive chemo benefit.