Would you consider doing Oncotype for a locoregional recurrence of ER positive breast cancer?  

To re-phrase the question, would evidence that a local recurrence is biologically more aggressive than the primary affect our recommendations about administering adjuvant chemotherapy in a patient who recurred on adjuvant endocrine therapy, especially if she had never received adjuvant chemotherapy?...

I wouldn't use RS in this instance unless I suspect a new primary. It might be useful to go back and understand why local failure occurred, how far out, treatment given in the past and what the patient is currently on, whether this seems to be a surgical issue or a disease biology issue,..etc. The r...

Thank you. That was very helpful.

Can be difficult to differentiate a LR from a new primary. ER/PR/HER2, grade, location of new event, timeline, etc. Sometimes it is blurred, and reviewing course and pathology/radiology in Tumor Board would be helpful to put the story together.