Steven N. Goodman, MD, MHS, PhD; Luigi Marchionni, MD, PhD; Antonio C. Wolff, MD
Potential Financial Conflicts of Interest: None disclosed.
Goodman S., Marchionni L., Wolff A.; Are Short-Term or Long-Term Recurrence Rates More Important in Breast Cancer Screening?. Ann Intern Med. 2008;149:357-358. doi: 10.7326/0003-4819-149-5-200809020-00015
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Published: Ann Intern Med. 2008;149(5):357-358.
We appreciate the points made by Dr. Rutgers and colleagues, which underscore messages of our article and the editorial by Simon (1). The authors are correct that the populations on which the 2 tests were validated differed in terms of pretreatment. They also differed by estrogen receptor status: The 70-gene test was validated on a mixed population of estrogen receptor–positive and –negative patients, whereas all of the OncotypeDX patients were estrogen receptor–positive. Although there may be an explanation for the reported differences, these are the numbers reported from the validation studies on which women have to base decisions, and they point out the difficulty of interpreting numbers for populations that may have mixed prognoses (estrogen-receptor–positive and –negative) and a mix of therapeutic choices (estrogen therapy or chemotherapy).
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