The 21-gene recurrence score in special histologic subtypes of breast cancer with favorable prognosis Journal Article
| Authors: | Turashvili, G.; Brogi, E.; Morrow, M.; Hudis, C.; Dickler, M.; Norton, L.; Wen, H. Y. |
| Article Title: | The 21-gene recurrence score in special histologic subtypes of breast cancer with favorable prognosis |
| Abstract: | Background/purpose: The 21-gene recurrence score (RS) assay predicts the likelihood of distant recurrence and chemotherapy benefit in early-stage, estrogen receptor (ER)-positive, HER2-negative breast cancer. Data on the RS of special histologic subtypes of invasive breast carcinoma with favorable prognosis are limited. Methods: We reviewed our institutional database to identify patients with special histologic subtypes of breast cancer associated with favorable prognosis and available RS results. Our cohort consists of fifty-seven women: thirty-three patients with pure mucinous carcinoma (MC), ten with tubular carcinoma (TC), nine with encapsulated papillary carcinoma (EPC), and five with solid papillary carcinoma (SPC). Results: Most (44/57, 77.2%) carcinomas had low RS (≤17), and none had high RS (≥31). All EPCs had low RS, but other subtypes had RS 18–30. Higher RS was associated with lower progesterone receptor (PR) expression by immunohistochemistry and lower PR mRNA scores (P ≤ 0.007). No morphologic feature (tumor grade, biopsy site changes, cellular stroma, inflammatory cells) was associated with RS ≥ 18. At a median follow-up of 40 months, the distant recurrence-free survival was 100%. One patient with SPC developed locoregional recurrence at 22 months. Conclusions: As the largest series to date, our study raises the question of whether the RS assay is necessary for breast cancers with favorable histology. Reflex testing of node-negative, ER+/HER2− breast cancers may be deferred for these special histologic subtypes, emphasizing the need for multidisciplinary discussions between breast pathologists and other members of the breast cancer team. © 2017, Springer Science+Business Media New York. |
| Keywords: | breast cancer; mucinous carcinoma; encapsulated papillary carcinoma; tubular carcinoma; favorable histology; 21-gene recurrence score assay; solid papillary carcinoma |
| Journal Title: | Breast Cancer Research and Treatment |
| Volume: | 165 |
| Issue: | 1 |
| ISSN: | 0167-6806 |
| Publisher: | Springer |
| Date Published: | 2017-08-01 |
| Start Page: | 65 |
| End Page: | 76 |
| Language: | English |
| DOI: | 10.1007/s10549-017-4326-1 |
| PROVIDER: | scopus |
| PUBMED: | 28577081 |
| PMCID: | PMC5572649 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 August 2017 -- Source: Scopus |
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