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New Online Breast Cancer Nomogram Predicts Oncotype DX Breast Cancer Recurrence Score

Amila Orucevic, MD, PhD, Associate Professor of Pathology, has created a nomogram to predict the Oncotype DX breast cancer recurrence score in collaboration with John Bell, MD, Professor and Director of the Cancer Institute; Alison McNabb, MS, Director of Health Information and Management Services; and Eric Heidel, PhD, Biostatistician and Assistant Professor. This nomogram can be used to help clinicians and patients evaluate the probability that a patient's breast cancer has a low-risk or a high-risk Oncotype DX recurrence score. The nomogram uses readily available clinical surrogates to predict a recurrence score otherwise obtained by pathology analysis.

Oncotype DX is a commercially available 21-gene breast cancer test that predicts the 10-year likelihood of breast cancer recurrence for patients treated with tamoxifen. It also helps determine the benefit of using chemotherapy along with anti-estrogen therapy for the same patients. Oncotype DX test is an expensive test and is used in approximately 30% of eligible breast cancer patients in the United States and in less than 20% of breast cancer patients in Europe. The nomogram created at the UT Graduate School of Medicine at the University of Tennessee Medical Center helps predict the Oncotype DX breast cancer recurrence test results without actually performing the test.

The team's project was published in the May issue of Breast Cancer Research and Treatment (DOI: 10.1007/s10549-017-4170-3) and outlines the utilization of this nomogram. The nomogram uses clinicopathologic variables readily available from any breast cancer patient pathology report to predict the Oncotype DX recurrence score.

"The use of breast cancer genomic prognostic assays, such as Oncotype DX, MammaPrint, EndoPredict and others, is an ideal way of practicing personalized medicine for each breast cancer patient. These assays provide prognosis for breast cancer patients while identifying ones for which chemotherapy treatment may not be necessary based on the analysis of the genetic makeup of the breast cancer cells of each individual breast cancer patient. Unfortunately, these tests are expensive and are not affordable or available for many breast cancer patients," said Dr. Orucevic.

"Therefore, our nomograms may be useful tools to help doctors worldwide select patients for which further Oncotype DX testing may or may not be necessary. They can also be used for patients who can't afford or access this testing," said Dr. Orucevic.

View the nomogram or learn more about the Cancer Institute.

Posted June 8, 2017


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