CAN WE SAFELY AVOID ONCOTYPE DX TEST IN HORMONE POSITIVE EARLY BREAST CANCER PATIENTS WITH LOW NHS PREDICT SCORE, TO AVOID CHEMOTHERAPY doc.kanika.26@gmail.com

 

CAN WE SAFELY AVOID ONCOTYPE DX TEST IN HORMONE POSITIVE EARLY BREAST CANCER PATIENTS WITH LOW NHS PREDICT SCORE, TO AVOID CHEMOTHERAPY

2

India

Oral or Poster

Personalised decision making is essential in the management of breast cancer. Currently, we utilise two different types of modalities to estimate the risk of recurrence, prognosis and benefit from adjuvant chemotherapy in patients with hormone positive early breast cancer. We compared Oncotype Dx and NHS Predict to see the concordance of the two tests and establish the utility of NHS Predict in resource-limited countries.

Patients with early breast cancer, who were hormone positive, Her2 negative with 0-3 positive nodes, and underwent ODX assay from 2008 to 2025 were entered into the study. Patients were stratified as per the ODX RS into low (RS : 0-20 for <= 50 years, 0-25 for >50years) and High (RS >21 for <= 50years and 26-100 for >50years) recurrence score. Absolute chemotherapy benefit (ACB) for each patient was calculated using NHS Predict 2.0 online tool, and patients were risk-stratified into low risk (ACB at 10 years <= 7%) and high risk (ACB >= 7%) so as to correspond to the ACB derived from ODX. The results were compared.

Out of 122 patients, 102 patients (83.6%) were classified into low RS and 20 patients (16.4%) were classified into high risk. As per NHS Predict, 49 patients were classified into low risk, 73 were high risk.

A high concordance between the low risk group of NHS predict and ODX was seen, concluding NHS Predict can help in decision making regarding adjuvant chemotherapy. In patients with discordant results, ODX may identify patients who could potentially benefit from chemotherapy.