21-gene recurrence score and locoregional recurrence in lymph node-negative, estrogen receptor-positive breast cancer Journal Article
| Authors: | Turashvili, G.; Chou, J. F.; Brogi, E.; Morrow, M.; Dickler, M.; Norton, L.; Hudis, C.; Wen, H. Y. |
| Article Title: | 21-gene recurrence score and locoregional recurrence in lymph node-negative, estrogen receptor-positive breast cancer |
| Abstract: | Background/purpose: The 21-gene recurrence score (RS) assay evaluates the likelihood of distant recurrence and benefit of chemotherapy in lymph node-negative, estrogen receptor (ER)-positive, HER2-negative breast cancer patients. The RS categories are associated with the risk of locoregional recurrence (LRR) in some, but not all studies. Methods: We reviewed the institutional database to identify consecutive female patients with node-negative, ER+/HER2− breast carcinoma tested for the 21-gene RS assay and treated at our center from 2008 to 2013. We collected data on clinicopathologic features, treatment, and outcome. Statistical analysis was performed using SAS version 9.4 or R version 3.3.2. Results: Of 2326 patients, 60% (1394) were in the low RS group, 33.4% (777) in the intermediate RS group, and 6.6% (155) in the high RS group. Median follow-up was 53 months. A total of 44 LRRs were observed, with a cumulative incidence of 0.17% at 12 months and 1.6% at 48 months. The cumulative incidence of LRR at 48 months was 0.84%, 2.72% and 2.80% for low, intermediate, and high RS groups, respectively (p < 0.01). Univariate analysis showed that the risk of LRR was associated with the RS categories (p < 0.01), T stage (p < 0.01) and lymphovascular invasion (LVI) (p = 0.009). There was no difference in LRR rates by initial local treatment (total mastectomy vs. breast-conserving surgery plus radiation therapy). The RS remained significantly associated with LRR after adjusting for LVI and T stage. Compared to patients with low RS, the risk of LRR was increased more than 4-fold (hazard ratio: 4.61, 95% CI 1.90–11.19, p < 0.01), and 3-fold (hazard ratio: 2.81, 95% CI 1.41–5.56, p < 0.01) for high and intermediate risk categories, respectively. Conclusions: Our study confirms that RS is significantly associated with the risk of LRR in node-negative, ER+/HER2− breast cancer patients. Our findings suggest that in addition to its value for prognostic stage grouping and decision-making regarding adjuvant systemic therapy, the role of the RS in identifying patients not requiring radiotherapy should be studied. © 2017, Springer Science+Business Media, LLC. |
| Keywords: | breast cancer; locoregional recurrence; recurrence score; 21-gene recurrence score assay |
| Journal Title: | Breast Cancer Research and Treatment |
| Volume: | 166 |
| Issue: | 1 |
| ISSN: | 0167-6806 |
| Publisher: | Springer |
| Date Published: | 2017-11-01 |
| Start Page: | 69 |
| End Page: | 76 |
| Language: | English |
| DOI: | 10.1007/s10549-017-4381-7 |
| PROVIDER: | scopus |
| PMCID: | PMC5647226 |
| PUBMED: | 28702894 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 November 2017 -- Source: Scopus |
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