Could Adjuvant Radiotherapy Be Avoided for Postmenopausal Patients With Node-Positive Estrogen Receptor–Positive Breast Cancer and Favorable Recurrence Score and SET2,3 Scores?

Reply to Y. Wang et al and Q. Sui et al

“…This has led to continued interest in using molecularly stratified tests, such as signatures predictive of systemic chemotherapy or endocrine therapy benefit, to identify women for whom RT may not be necessary. Even in the cohort of patients from SWOG 8814, as suggested by Wang and Cai, 4 OncotypeDx has been previously evaluated in a subset of patients with node-positive breast cancer and the recurrence score was found to be associated with locoregional recurrence risk in certain subsets of the study, but not others. 9 As SWOG 8814 included women with node-positive breast cancer who were managed surgically with either mastectomy or BCS with heterogeneous use of RT, we do not feel this is the best choice to evaluate the value of SET 2,3 in answering RT benefit questions.…”