Younger patients with breast cancer who received the 21-gene recurrence score (RS) assay had reduced use of adjuvant chemotherapy and had lower health care costs than patients older than 55 years, according to a study published online ahead of print in the Journal of Clinical Oncology.1

In this study, investigators sought to determine the associations between RS, subsequent chemotherapy use, and health care costs.

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Investigators used data from the Pennsylvania Cancer Registry to create a group of women with early stage breast cancer who underwent surgical treatment from 2007 to 2010. These data were compared with administrative claims from the 12-month periods before and after diagnosis to identify comorbidities, treatments, and cost (n = 7287).

The effect of RS on chemotherapy use and expenditure the year after diagnosis was estimated by using propensity-score weighted regression models.

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Results showed that age was the biggest determining factor between use of RS and outcomes. Women younger than 55 who used RS had a 19.5% lower rate of chemotherapy administration (95% CI, 10.6 – 27.9). Women between 75 and 84 years who used RS had 5.7% higher rate of chemotherapy use (95% CI, 0.4 – 11.0). Similarly, younger women who used RS had lower medical expenditures than did older women.


  1. Epstein AJ, Wong Y-N, Mitra N, et al. Adjuvant chemotherapy use and health care costs after introduction of genomic testing in breast cancer [published online ahead of print November 23, 2015]. J Clin Oncol. doi: 10.1200/JCO.2015.61.9023.