Guidance to help inform treatment decisions



3 ways this test can help
The Breast Recurrence Score® assay
- Uses your patient’s unique tumor tissue sample
3 - Assesses the expression of 21 genes
3 - 16 cancer-related genes
- 5 reference genes
- Uses reverse transcription polymerase chain reaction (RT-PCR) to analyze tumor RNA
3 - Uses tissue obtained at the time of core biopsy or surgical excision
7
A comprehensive genomic assessment
- Includes the estimated risk of distant recurrence with endocrine therapy alone
3,6 - Helps predict the benefit of adding chemotherapy to endocrine therapy
1,2
Quantitative single-gene scores
- Quantitative estrogen receptor (ER) score helps assess the magnitude of hormonal therapy benefit
3 - Provides additional supporting information, such as progesterone receptor (PgR) and HER2 scores
3,9

Backed by a solid body of clinical evidence
Included in major international breast cancer treatment guidelines
The 21-gene assay (Oncotype DX®) is included in leading international oncology guidelines, including those from the National Comprehensive Cancer Network® (NCCN®), the American Society of Clinical Oncology, and the European Society for Medical Oncology (ESMO).
- The only genomic assay with the highest recommendation in 5 major international guidelines for risk assessment in patients with early-stage breast cancer
8,11-14 - Included as a recommendation in 2 additional guidelines
15,16
*National Comprehensive Cancer Network and NCCN are registered trademarks of the National Comprehensive Cancer Network.

Not all genomic tests are created equal

Is your patient eligible?
The Oncotype DX Breast Recurrence Score test is appropriate for patients who are:
- Recently diagnosed with invasive breast cancer
- Anatomic stage I, II, or IIIa
- Hormone receptor-positive (HR+)
- Human epidermal growth factor receptor 2-negative (HER2-)
- Node negative (N0) or node positive (N1mic or N1)
- Medically eligible for chemotherapy
NOTE: Your patients diagnosed with noninvasive breast cancer, ductal carcinoma in situ (DCIS), may be eligible for the
86% of patients paid $0
91% paid less than $100*

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References
- Paik S, Tang G, Shak S, et al. Gene expression and benefit of chemotherapy in women with node-negative, estrogen receptor-positive breast cancer. J Clin Oncol. 2006;24(23):3726-3734.
- Albain KS, Barlow WE, Shak S, et al. Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogen-receptor-positive breast cancer on chemotherapy: a retrospective analysis of a randomised trial. Lancet Oncol. 2010;11(1):55-65.
- Paik S, Shak S, Tang G, et al. A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 2004;351(27):2817-2826.
- Sparano JA, Gray RJ, Makower DF, et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med. 2018;379(2):111-121.
- Kalinsky K, Barlow WE, Gralow JR, et al. 21-gene assay to inform chemotherapy benefit in node-positive breast cancer. N Engl J Med. 2021;385(25):2336-2347.
- Dowsett M, Cuzick J, Wale C, et al. Prediction of risk of distant recurrence using the 21-gene recurrence score in node-negative and node-positive postmenopausal patients with breast cancer treated with anastrozole or tamoxifen: a TransATAC study. J Clin Oncol. 2010;28(11):1829-1834.
- Jakubowski DM, Bailey H, Abran J, et al. Molecular characterization of breast cancer needle core biopsy specimens by the 21-gene Breast Recurrence Score test. J Surg Oncol. 2020;122(4):611-618.
- Referenced with permission from the NCCN Clinical Practice Guidelines In Oncology (NCCN Guidelines®) for Breast Cancer V.4.2025. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed April 28, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
- Kim C, Tang G, Pogue-Geile KL, et al. Estrogen receptor (ESR1) mRNA expression and benefit from tamoxifen in the treatment and prevention of estrogen receptor-positive breast cancer. J Clin Oncol. 2011;29(31):4160-4167.
- Data on file as of January 27, 2025, at Genomic Health, Inc.
- Andre F, Ismaila N, Allison KH, et al. Biomarkers for adjuvant endocrine and chemotherapy in early-stage breast cancer: ASCO guideline update. J Clin Oncol. 2022;40(16):1816-1837.
- AGO Breast Committee. Diagnosis and Treatment of Patients With Early and Advanced Breast Cancer. Version 2024. 1E. Accessed March 31, 2025. https://www.ago-online.de/fileadmin/ago-online/downloads/_leitlinien/kommission_mamma/2024/englisch/Einzeldateien/AGO_2024E_26_Therapy_algorithms.pdf
- Cardoso F, Kyriakides S, Ohno S, et al. Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2019;30(8):1194-1220.
- Hortobagyi GN, Connolly JL, D'Orsi CJ, et al. Breast. In: Amin MB, Edge SB, Greene FL, et al, eds. AJCC Cancer Staging Manual. 8th ed. Springer; 2017:589-636.
- National Institute for Health and Care Excellence (NICE) Guidelines. Tumor profiling tests to guide adjuvant chemotherapy decisions in early breast cancer. Published May 9, 2024. March 31, 2025. https://www.nice.org.uk/guidance/dg58
- Burstein HJ, Curigliano G, Loibl S, et al. Estimating the benefits of therapy for early-stage breast cancer: the St. Gallen International Consensus Guidelines for the primary therapy of early breast cancer 2019. Ann Oncol. 2019;30(10):1541-1557.
Oncotype DX, Oncotype DX Breast DCIS Score, Oncotype DX Breast Recurrence Score, Breast Recurrence Score, and Recurrence Score are registered trademarks of Genomic Health, Inc., a wholly-owned subsidiary of Exact Sciences Corporation. Exact Sciences is a registered trademark of Exact Sciences Corporation. All other trademarks are the properties of their respective owners.
The Oncotype DX Breast Recurrence Score test was developed, and the performance characteristics validated by Genomic Health, Inc., a wholly-owned subsidiary of Exact Sciences Corporation following College of American Pathologists (CAP) and Clinical Laboratory Improvement Amendments (CLIA) regulations. The Oncotype DX Breast Recurrence Score test is performed at the Genomic Health Redwood City clinical laboratory. Exact Sciences clinical laboratories are accredited by CAP, certified under CLIA regulations, and qualified to perform high-complexity clinical laboratory testing. This test has not been cleared or approved by the US Food and Drug Administration or other notified regulatory authority.