Jailan Elayoubi

Abstract Treatment selection in breast cancer is guided by risk assessment using molecular subtypes and clinicopathological characteristics. However, current approaches lack the precision required for optimal clinical decision-making. To address this, we use data from 8161 patients to develop and evaluate an AI test integrating digital pathology with clinical data. The AI test provides a robust method for predicting disease-free interval (C-index: 0.71 [0.68-0.75], HR: 3.63 [3.02-4.37, p < 0.001]).

Background While the RxPONDER trial was a landmark study demonstrating that Oncotype DX (ODX) can guide adjuvant chemotherapy use in postmenopausal women with 1 to 3 positive nodes and an ODX score of 25 or less, ODX was not predictive in premenopausal women. Therefore, current NCCN guidelines recommend ODX as a consideration but leaves decision-making up to the discretion of the physician.