I would want pathology to be reviewed again to see if there are ER+ and ER- areas, to explain the discordance in ER expression via Oncotype Dx and IHC. It is possible that the Oncotype Dx was run on the ER- portion. 

Here we have the problem of measuring either the protein or RNA. both test do not give us an idea whether the estrogenic pathway is active. Therefore I suggest to use either Prosigna or Blueprint/Mammaprint! Both tests determine the activity / or not of the ER pathway hence give us an answer if the ...