Is there value to OncoType Dx and/or NGS testing for mutations such as ESR1 in patients who have ipsilateral isolated resectable skin recurrence in ER+ positive low Oncotype breast cancer 10 years after mastectomy and adjuvant AI for 5 years?  

I would not order an Oncotype on this tumor if it is a delayed locoregional chest wall recurrence. These LRR events are at higher risk of distant disease and we don't have data on how prognostic or predictive the ODX score is in these scenarios. NGS is also of limited utility but may be helpful if a...