21-Gene Recurrence Scores of 26 or Higher Can Help Determine If Chemotherapy Will Be Effective Interview with:

  • Sung Jun Ma, MD, resident physician in Radiation Medicine at Roswell Park Comprehensive Cancer Center (first author)
  • Oluwadamilola T. Oladeru, MD, a resident physician at Massachusetts General Hospital Cancer Center What is the background for this study?

Response: More than 40% of women with hormone receptor-positive, HER2-negative early-stage breast cancer have high recurrence scores (RS) of 26-30. Optimal adjuvant systemic therapy in this subgroup remains unclear, and national guidelines currently recommend either chemoendocrine therapy or endocrine therapy alone. In addition, the difference in overall survival of a patient with a RS 26-30 versus RS >30 is unclear. What are the main findings?

Response: Our main findings are:

1) Chemotherapy improves outcomes for those with RS 26-30,

(2) RS >30 carries a worse prognosis for survival compared to RS 26-30 despite receiving chemoendocrine therapy, and

(3) The magnitude of chemotherapy benefit appears to be similar between those with RS 26-30 and RS >30. What should readers take away from your report?

Response: Breast cancer patients with a 21-gene recurrence score of 26 or higher are a heterogeneous group of patients with different prognosis and outcomes, and chemotherapy may benefit patients with recurrence scores of 26-30. What recommendations do you have for future research as a result of this work?

Response: Further prospective studies are needed to investigate optimal adjuvant therapy regimens for patients with a high 21-gene recurrence score 

No relevant disclosures


Ma SJ, Oladeru OT, Singh AK. Association of Adjuvant Chemotherapy With Overall Survival in Patients With Early-Stage Breast Cancer and 21-Gene Recurrence Scores of 26 or Higher. JAMA Netw Open. 2020;3(5):e203876. doi:10.1001/jamanetworkopen.2020.3876




The information on is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.


Last Updated on May 14, 2020 by Marie Benz MD FAAD