Assessing the prognostic utility of Oncotype Dx among patients with ER-low-positive breast cancer in the National Cancer Database (NCDB)

Q: What does this research mean for the field?

Oncotype Dx is prognostic in ER-low-positive, node-negative, early-stage breast cancer, with low/intermediate recurrence scores associated with improved survival compared to high scores. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Madelyn Klugman; Ruizhe Chen; Maya Aboumrad; Catherine H. Marshall; Antonio C. Wolff; Jenna V. Canzoniero; Kala Visvanathan

doi:10.1038/s41523-026-01032-w

September 11, 2026npj Breast CancerOpen Access

Assessing the prognostic utility of Oncotype Dx among patients with ER-low-positive breast cancer in the National Cancer Database (NCDB)

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Key Points

To evaluate the prognostic utility of the Oncotype DX recurrence score in patients diagnosed with estrogen receptor-low-positive, node-negative breast cancer.
Retrospective cohort study using data from the National Cancer Database (NCDB).
Analyzed N=2,975 patients with ER-low-positive, node-negative early-stage breast cancer eligible for Oncotype DX testing.
Evaluated the association between Oncotype DX recurrence score categories (low/intermediate vs. high) and survival outcomes using multivariable models.
A low or intermediate Oncotype DX recurrence score was significantly associated with improved survival compared with a high score in multivariable analysis (HR = 0.57, 95% CI = 0.33–0.98).
Findings confirm that Oncotype DX provides prognostic value for risk stratification in early-stage, node-negative, ER-low-positive breast cancer.

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Implication

Retrospective cohort study reveals improved survival with low or intermediate Oncotype DX scores in ER-low-positive breast cancer, highlighting its prognostic value.

Abstract

Oncotype Dx (ODX) has not been evaluated in estrogen receptor (ER)-low-positive breast cancer (BC), a rare subtype with heterogeneous behavior. In this retrospective cohort of 2975 patients with ER-low-positive, node-negative BC eligible for ODX testing, a low/intermediate ODX recurrence score was associated with improved survival compared with a high ODX in multivariable models (hazard ratio = 0.57, 95% confidence interval = 0.33–0.98). These findings suggest that ODX is prognostic in ER-low-positive, node-negative, early-stage BC.

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Klugman et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b2890926e14a848b0f38 https://doi.org/10.1038/s41523-026-01032-w

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Assessing the prognostic utility of Oncotype Dx among patients with ER-low-positive breast cancer in the National Cancer Database (NCDB)

Key Points

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Implication

Abstract

Discussion

Cite This Study

Assessing the prognostic utility of Oncotype Dx among patients with ER-low-positive breast cancer in the National Cancer Database (NCDB)

Key Points

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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