Would you consider using OncoType Dx testing in a patient with breast cancer if nodal evaluation is not performed?

In women who are 65 and older who have clinically negative axilla, there are less node assessments done with BCS, given data showing they do not add very much. If the patient is otherwise a candidate for adjuvant chemotherapy, I do check a genomic expression profile, either OncotypeDX or MammaPrint. MammaPrint offers the opportunity of no adjuvant therapy if it shows an ultra-low risk result (Esserman et al., PMID 28662222).