Abstract

Objective. The aim of this study is to assess the impact of Oncotype DX on treatment decisions and healthcare economy.

Methods. Data were retrospectively collected from Fondazione Policlinico Universitario Campus Bio-Medico of Rome. 313 female patients with HR-positive, HER2-negative breast cancer underwent Oncotype DX between August 2020 and January 2024. Recurrence score, recurrence risk and chemotherapy benefit were collected from Oncotype DX report. Clinical and pathological data were collected. To objectify the oncological prescription based on clinicopathological variables, we used PREDICT 2.2 algorithm. Reimbursements, hospital accesses and number of health services in one-year follow-up were also collected.

Results. Oncotype DX did not indicate chemotherapy in 223/313 (71.2%) patients. In the PREDICT 2.2 scenario, 147/313 (47%) patients were not indicated chemotherapy. Thus, genomic test approach led to a decrease of 24.2% in chemotherapy prescription. Patients receiving chemotherapy had 21 (+91.3%) more hospital accesses, 115 (+101.8%) more health services and a reimbursement of €2811 (+31.5%) higher than patients not receiving chemotherapy (median values).

Conclusions. Oncotype DX results in lower rates of chemotherapy prescription and in possible healthcare cost savings.

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Authors

Alessia Capozzi - Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, 00128, Roma, Italy https://orcid.org/0009-0003-0733-4804

Silvia Maria Rossi - Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, 00128, Roma, Italy https://orcid.org/0000-0002-9758-2099

Giovanna Sabarese - Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Roma, Italy https://orcid.org/0000-0002-6841-1610

Marco Germani - Service of cost accounting and reporting, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Roma, Italy

Gabriella Gullotta - Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Roma, Italy

Stefania Sfregola - Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Roma, Italy

Giuseppe Perrone - Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, 00128, Roma, Italy. Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Roma, Italy https://orcid.org/0000-0002-9538-5729

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Copyright (c) 2025 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology

How to Cite
Capozzi, A., Rossi, S. M., Sabarese, G., Germani, M., Gullotta, G., Sfregola, S., & Perrone, G. (2025). Oncotype DX in clinical practice: impact on treatment decisions and healthcare system economy. Pathologica - Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology, 117(4). https://doi.org/10.32074/1591-951X-N1139
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