Would you send Oncotype for pre-menopausal women with HR+, HER2(-) breast cancer with a small tumor (pT1b) and micrometastatic LN involvement or recommend adjuvant chemotherapy without sending Oncotype?

That is a very good question, especially considering that the RxPONDER trial showed benefit from chemotherapy in pre-menopausal women with 1-3 lymph nodes involved by breast cancer. However, this trial excluded patients who had micro-metastatic disease as the only nodal involvement, so we can't appl...