(A) Proportion of patients with N0, estrogen receptor–positive breast cancer classified as low, intermediate, and high risk by recurrence score (RS) and RS-pathology-clinical assessment (RSPC), and (B) cross-classification of patients (N = 1,444). Cochran-Mantel-Haenszel (CMH) test compares RS with RSPC for the proportions of patients in the three risk classes. Average risk for each risk group is the meta-analysis weighted average estimate (with 95% CI) of the 10-year incidence of distant recurrence (DR). Average risks are not significantly different between RS and RSPC (P = .68, .27, .42 for low-, intermediate-, and high-risk groups, respectively, z-test); average risk significantly increases with increasing risk group (P < .001 for both RS and RSPC, z-test for trend).