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Oncotype DX 21-Gene Recurrence Score

Oncotype DX is a 21-gene genomic assay that calculates a Recurrence Score (RS) from 0-100 for early-stage HR+/HER2- breast cancer, predicting distant recurrence risk and chemotherapy benefit.

Purpose:
Predict distant recurrence risk and determine chemotherapy benefit in early breast cancer
Population:
HR+/HER2- early-stage breast cancer (node-negative or 1-3 positive nodes)
Factors:
16 cancer-related genes, 5 reference genes, Recurrence Score 0-100
Reference:
Sparano et al., NEJM 2018 (TAILORx)
HomeOncotype DX Recurrence Score Calculator — Breast Cancer Genomic Risk
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Oncotype DX Recurrence Score Calculator — Breast Cancer Genomic Risk

Clinical Context & Background

The Oncotype DX Breast Recurrence Score test predicts the benefit of chemotherapy in ER+, HER2- early breast cancer. This tool interprets the score based on age and nodal status, referencing pivotal data from the TAILORx (Node Negative) and RxPONDER (Node Positive 1-3) trials.
Primary Source EvidenceSparano JA, et al. Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer. N Engl J Med. 2018;379(2):111-121. (TAILORx); Kalinsky K, et al. N Engl J Med. 2021;385:2336-2347. (RxPONDER)
Formula Logic
Lookup based on Score (0-100), Age, and Nodal Status.

Reference Data

RS RangeNodal StatusChemo Benefit
0 - 25N0 (Age > 50)No Benefit
0 - 15N0 (Age ≤ 50)No Benefit
16 - 25N0 (Age ≤ 50)Some Benefit (~6-9% in 21-25 range)
26 - 100AnyClear Benefit
0 - 25N1 (1-3 nodes)Premenopausal: Benefit. Postmenopausal: No Benefit.

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