The Oncotype DX assay is one of the molecular tests that provide predictive and 
prognostic information to breast cancer patients with estrogen receptor 
(ER)-positive and node-negative disease. This study evaluates the association of 
Forkhead-box protein A1 (FOXA1) and GATA-binding protein 3 (GATA3) expressions 
with Oncotype DX recurrences scores in 77 cases of patients with ER-positive 
node-negative breast carcinomas diagnosed at Indiana University. The data were 
correlated with patient age, tumor size, histologic type, 
Scarff-Bloom-Richardson score, histologic grade, and progesterone receptor 
status. The median FOXA1 and GATA3 scores were 240 and 200, respectively. The 
Oncotype DX recurrence scores were low in 57%, intermediate in 30%, and high in 
13% of cases. FOXA1 expression correlated negatively with Oncotype DX recurrence 
scores (P=0.004), and histologic type (P=0.0004). Oncotype DX recurrences score 
also correlated negatively with progesterone receptor (P=0.035) with 100% of 
progesterone receptor-negative cases having high or intermediate Oncotype DX 
scores. FOXA1 and GATA3 expressions correlated positively (P=0.014). The 
correlation between FOXA1 expression and Oncotype DX recurrence scores remained 
significant after adjusting for multiple comparisons and controlling for 
confounders such as histological type, grade, and progesterone receptor. A 
statistically significant correlation between the Oncotype DX recurrence scores 
and FOXA1 expression in our diverse cohort of ER-positive breast cancer patients 
was observed. We propose that this may represent a more cost-effective strategy 
to further risk stratify patients with good prognosis in whom chemotherapy may 
be omitted. To confirm these findings, further studies in a larger cohort of 
patients are warranted.