For years we have been treating Oncotype DX Low Recurrence Risk patients with endocrine therapy ( ie:Tamoxifen; Aromatase Inhibitors ), and High Recurrence Risk patients with chemotherapy and endocrine therapy but we have not known the outcome of patients at Intermediate Recurrence Risk .
At the 2018 ASCO meeting results of the Tailor Trial Intermediate Risk breast cancer patients with early breast cancer was presented and is practice changing.
In this trial Intermediate Risk patients were randomized to either endocrine therapy, or chemotherapy plus endocrine therapy. Based on their findings, it now appears that the majority of Intermediate Risk Recurrence postmenopausal patients can safely be given endocrine therapy alone and derive the same benefit in risk reduction of recurrence as those with chemotherapy and endocrine therapy. Premenopauasal patients recommendations are different and particularly those who have scores of 21 or more should get chemotherapy since there is a benefit in recurrence risk.
Of course each patient is different and final therapy decisions are based on clinical variables and a discussion between the patient and their physician