There was no difference in the use of Oncotype DX (ODX) between black and non-black patients with node-negative breast cancer. However, for women with node-positive breast cancer, black patients were less likely to receive ODX evaluation.
Racial Variation in the Uptake of Oncotype DX Testing for Early-Stage Breast Cancer
Authors: Roberts M, Weinberger M, Dusetzina SB, et. al.
Source: J Clin Oncol. 2016;34:130-138.
The Carolina Breast Study collects data among female breast cancer patients across 44 counties in North Carolina, and provided the patients for this study. Almost 1500 women with unifocal, ER+, HER2-, stage I or II breast cancer were evaluated. The use of ODX for each woman was noted. Among women with node negative disease, there was no disparity between black and non-black women and ODX use. However, among women with node-positive disease, black women were less likely to receive ODX evaluation. The investigators provided several theories for this discrepancy. The use of ODX in node-positive disease remains under investigation, and patients who do receive evaluation in North Carolina are usually enrolled in the RxPONDER clinical trial. This trial has a low-recruitment rate among black women. Also, ODX in node-positive disease is not routinely covered by health insurance. As there is a correlation between socioeconomic status and race, concerns about perceived cost may pose unique barriers to black patients. Finally, as current guidelines do not recommend ODX evaluation in patients with node-positive disease, lower rates of testing among black women with node-positive breast cancer may simply reflect their receipt of guideline-concordant care. There are opportunities for further investigation into these differences.