Adjuvant chemotherapy in T1a/bN0 breast cancer with a high 21-gene recurrence score (>25): A 10-year follow-up in a real-world cohort Journal Article
| Authors: | Katz, D.; Feldhamer, I.; Wolff-Sagy, Y.; Goldvaser, H.; Hammerman, A.; Goldstein, D. A. |
| Article Title: | Adjuvant chemotherapy in T1a/bN0 breast cancer with a high 21-gene recurrence score (>25): A 10-year follow-up in a real-world cohort |
| Abstract: | Background In ER + /HER2- early breast cancer (BC), 21-Gene Recurrence Score (RS) > 25 indicates high-risk of distant-recurrence and predicts benefit from adjuvant chemotherapy (aCT) regardless of tumor-size. However, T1a/b (<= 1 cm) node-negative (N0) tumors, regarded as of low risk of recurrence, were under-represented in the RS trials. We therefore aimed to investigate the benefit of aCT in patients with T1a/bN0 BC, RS > 25, where clinical and genomic risk indicators are discordant. Methods This retrospective observational cohort study utilized Israel's national Oncotest database to identify Clalit Health Services (CHS) members, diagnosed with T1a/bN0 HR + /HER2- BC, who underwent RS testing between February 2006, and December 2019. Patients with RS > 25 who received aCT were matched 1:1 by propensity-scoring to similar patients receiving no aCT. Invasive disease-free survival (iDFS) and distant recurrence were the study endpoints. Patient demographic and clinical data were obtained from CHS's centralized database. Kaplan--Meier analysis with log-rank testing was used for comparing outcomes. Results During the study period, high-risk RS result (> 25) was identified in 156/9858 patients of the study cohort. aCT was administered to 74 (47.4%) and median follow-up was 121 months. Within the 148 matched-cases, eighteen iDFS-events occurred, nine (12.1%) in each group (chi(2) = 0.72, p = 0.39). Four (5.4%) of the aCT treated and three (4.0%) of the untreated patients were diagnosed with distant recurrence (chi(2) = 0.22, p = 0.64). Conclusions In this study cohort, patients with T1a/bN0 BC, RS > 25 that received aCT, did not have improved outcomes and the 21-Gene RS > 25 was not found to be predictive, possibly due to the low number of events observed. |
| Keywords: | chemotherapy; breast cancer; assay; expression; clinical-outcomes; adjuvant; aid; treatment decisions; 70-gene signature; oncotypedx (c); t1/bn0 |
| Journal Title: | Breast Cancer |
| Volume: | 32 |
| Issue: | 2 |
| ISSN: | 1340-6868 |
| Publisher: | Springer Japan KK |
| Date Published: | 2025-03-01 |
| Start Page: | 286 |
| End Page: | 291 |
| Language: | English |
| ACCESSION: | WOS:001366238100001 |
| DOI: | 10.1007/s12282-024-01652-9 |
| PROVIDER: | wos |
| PMCID: | PMC11842534 |
| PUBMED: | 39602054 |
| Notes: | Article -- Source: Wos |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
Related MSK Work