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BRCA Gene Mutations in Cancer / Breast Cancer Treatment Studies · Journal article
Cancers · August 18, 2026
Encouraging direction, but not yet definitive.
This retrospective cohort study of 2,577 breast cancer patients examined whether Oncotype DX recurrence scores predict mortality and recurrence differently in Black/African American versus non-Hispanic White patients. Black/AA patients had significantly higher mortality overall (49% greater hazard), and in the lowest Oncotype DX score category (0–16) had 73% greater mortality risk; however, other score categories did not show statistically significant racial differences, suggesting performance of the test may vary by risk stratum and race.
Retrospective cohort study. Patients ages 18–75 years with newly diagnosed breast cancer who received Oncotype DX testing at Kaiser Permanente; Black/African American and non-Hispanic White patients compared.. Intervention: Oncotype DX testing and stratification by recurrence score category (0–16, other categories specified in multivariable models).. Compared with: Comparison by race (Black/African American vs. non-Hispanic White) and Oncotype DX score category.. n = 2,577. Kaiser Permanente (health system; specific geographic locations not stated)..
Black/AA patients had 49% greater risk of mortality than NHW patients overall (multivariable p = 0.0444) Black/AA patients with Oncotype DX score 0–16 had 73% greater risk of mortality than NHW patients (multivariable p = 0.0409) Oncotype DX score differences associated with mortality in overall sample (multivariable p = 0.0281)
Retrospective design; unmeasured confounders (comorbidities, socioeconomic factors, treatment adherence) may explain mortality differences. Absolute mortality rates, follow-up duration, and chemotherapy/endocrine therapy receipt rates by race and score category not reported.
These findings suggest that Oncotype DX may not predict outcomes uniformly across racial groups, particularly in the lowest-risk score category where Black/AA patients face unexpectedly high mortality despite favorable recurrence scores. Clinicians should be cautious about relying on Oncotype DX scores alone to inform treatment decisions in Black/AA patients and should recognize that other biological, social, or care factors may account for the observed mortality gap.
A retrospective cohort study of adequate size reporting statistically significant mortality differences by race and Oncotype DX score, but with limited scope (single health system) and inconsistent significance across score categories, requiring confirmation in diverse populations.
As stated by the source record.
Quoted from the source exactly as published.
These findings suggest that Oncotype DX may not predict outcomes uniformly across racial groups, particularly in the lowest-risk score category where Black/AA patients face unexpectedly high mortality despite favorable recurrence scores. Clinicians should be cautious about relying on Oncotype DX scores alone to inform treatment decisions in Black/AA patients and should recognize that other biological, social, or care factors may account for the observed mortality gap.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background: It is well documented that Black and African American (AA) patients have the highest risk of recurrence of breast cancer. However, less is known about racial differences in gene expression profiling tests such as Oncotype DX that predicts cancer recurrence. This study aimed to assess the predictive differences in Oncotype DX scores for breast cancer outcomes between Black/AA and non-Hispanic White patients. Methods: We identified Oncotype DX testing status in patients ages 18–75 years who were newly diagnosed with breast cancer, assessed race and other factors among patients with different testing statuses, and described the distribution of the Oncotype DX score. Additionally, we assessed treatment, and multifactorial impact on outcomes by Oncotype DX score, including: receipt of chemotherapy, endocrine therapy, stage, and disease-related recurrence and mortality. Results: We identified 2577 eligible patients for the analysis. Black/AA patients had a 49% greater risk/hazard of mortality than non-Hispanic White (NHW) patients (multivariable model p-value 0.0444). Oncotype DX score differences were associated with mortality in the overall sample (multivariable model, p-value = 0.0281). Specifically, in the Oncotype DX-specific models, Black/AA patients with an Oncotype DX score of 0–16 had 73% greater risk of mortality than NHW patients (multivariable model p-value 0.0409). While all other Oncotype DX score categories showed elevated risks of mortality, they were not statistically significant. The Oncotype DX-specific multivariable models showed that, compared to NHW patients, recurrence was lower for Black/AA patients in the lower categories and higher in the upper categories, but results were not statistically significant. Conclusions: This study assessed recurrence and mortality outcomes by the recurrence score and found significantly higher rates of mortality among Black/AA patients in the lowest recurrence score category. Other studies have shown that recurrence scores add prognostic value during diagnosis. However, examining performance of these tools among diverse populations is imperative.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.