Do you give chemotherapy to women with clinical features of high risk ER+ breast cancer, but a low Oncotype DX score?   

I wouldn't consider chemotherapy in this patient but some would. I will try to briefly summarize the arguments on both sides. - Prior to oncotype, we made the decision about chemo based on anatomic risk alone. If the risk of recurrence was predicted to be 10% or greater, guidelines suggested chemot...

I agree with Dr. @Kathy Miller's response for this T2N0 tumor; what gets more complicated is truly clinical high risk disease such as node-positive. While it is true that few 35 year olds were included in the trial, and estrogen sensitivity differs in pre- and post-menopausal breast cancer, it does ...

I agree with my colleagues above. Genomic tests such as the 21 gene assay appear when low risk to select for disease which has a more benign hormonally driven biology. The fascinating question in a younger woman is whether the adjustments of the 21 gene assay based on TAILORx (chemo benefit in ...

Since she has node-negative disease, I would discuss avoiding chemo if in the low risk range. Would consider ovarian suppression as an alternative if low risk or low intermediate risk.