Études de cas | Oncotype DX Breast Recurrence Score®

Physician Name*

Primary Affiliation*

Location (city, state)*

Country*

Email Address*

Patient Consent* Yes No

Age (at diagnosis)*

Menopausal Status* Pre-Menopausal Peri-Menopausal/Unknown Post-Menopausal

Gender* Male Female

Tumor Type* Ductal Lobular

Number of Lymph Nodes Affected* 0 Micrometasasis 1 2 3 >3

Tumour Size (cm)*

Histologic Grade* 1 2 3

ER Expression Level* Positive Negative %

PR Expression Level* Positive Negative %

HER2/NEU Status* IHC 0 (negative) IHC 1+ (negative) IHC 2+ & ISH- (negative) IHC 2+ & ISH+ (positive) IHC 3+ (positive)

Ki67 Expression (optional) %

General Health*

Recurrence Score® result*

Treatment Decision*

Other Information

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