21-Gene Recurrence Score Testing in HER2-positive Patients

Research output: Contribution to journalArticle


Introduction: The 21-gene recurrence score (RS) has been extensively studied and validated in patients with estrogen receptor-positive (ER + ), human epidermal growth factor 2 (HER2)-negative breast cancer; however, RS testing is not routinely performed in patients with HER2-positive (HER2 + ) disease. We sought to determine patterns of RS testing, to characterize RS distributions, and to determine the impact of RS results on clinical decision-making for patients with ER + , HER2 + breast cancer. Materials and Methods: Using the Surveillance and Epidemiology End Results program database, we identified women with ER + , HER2 + breast cancer. We stratified patients using TAILORx RS cutoffs and evaluated treatment characteristics across patients. Multivariable logistic regression was performed to determine factors associated with RS testing and receipt of a high-risk RS. Results: Overall, 5% of patients with ER + , HER2 + , early stage breast cancer underwent RS testing. The distribution of RS testing by TAILORx cutoffs were: high-risk, 17%; intermediate-risk, 49%; and low-risk, 34%. Chemotherapy utilization among those not tested was 66%. Among those tested, utilization was significantly associated with RS results: 67% of high-risk, 30% of intermediate-risk, and 19% of low-risk patients received chemotherapy. Progesterone receptor-negative status, larger tumor size, and high tumor grade were significantly associated with high-risk RS. Conclusions: RS testing is used sparingly among patients with HER2 + early-stage breast cancer; however, test results appear to impact clinician's decision-making on chemotherapy use.

Original languageEnglish (US)
Pages (from-to)126-130
Number of pages5
JournalClinical Breast Cancer
Issue number2
StatePublished - Apr 2019



  • Breast cancer
  • HER2-positive
  • Recurrence score testing

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't

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