Dieci MV, et al. - Researchers assessed how adjuvant treatment decision for patients with early breast cancer was influenced by 21-gene Recurrence Score (RS) results in the ROXANE Italian prospective study performed in 9 centers. For cases with estrogen receptor-positive/human epidermal growth receptor 2-negative, T1–T3, N0–N1 early breast cancer, the RS test was used by physicians in the presence of uncertainty regarding adjuvant treatment recommendation. This study included 251 patients. Compared with N1 patients, a higher grade and higher Ki67 and more frequently being progesterone receptor negative was noted in N0 patients (61%). The 21-gene assay was predominantly used in N0 patients with a more aggressive biology or in N1 patients demonstrating more indolent biology. The rate of change in treatment decision with the use of RS testing was 30% in this selected patient population. Findings revealed that chemotherapy use reduced by more than half in the N1 patient subgroup as a result of using RS testing.