Abstract
AimThe current study aimed to explore the distribution patterns of 21-gene recurrence score (RS) assay in Chinese early breast cancer patients.MethodsNine hundred and eighty consecutive estrogen receptor(ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer patients treated at Ruijin Hospital, Shanghai Jiaotong University, School of Medicine from 2009 to 2016 were retrospectively recruited. Reverse transcriptase-polymerase chain reaction (RT-PCR) assay of 21 genes were conducted in paraffin-embedded tumor tissue to calculate the RS. Co-relations of RS and clinico-pathologic factors were evaluated. Concordances of RT-PCR and immunohistochemistry (IHC) tests were measured. Logistic regression were applied to determine independent variables associated with RS.ResultsThe median RS of 980 patients was 23(0~90), and the proportions of patients categorized as having a low, intermediate, or high risk were 26.1%, 49.3% and 24.6%. The distribution of RS varied significantly according to different tumor grade, T stage, progesterone receptor(PR) status, Ki67 index and molecular subtypes (p<0.05). Grade, PR status and Ki67 index were identified as independent variables associated with RS. The concordance rates between RT-PCR and IHC test were 98.8% and 88.3% for ER and PR status, and there were weak to moderate correlation between IHC and RT-PCR tests for ER, PR expression and Ki67 index.ConclusionsRS correlated significantly with grade, T stage, PR status, Ki67 index and molecular subtypes in Chinese early breast cancer patients. Grade, PR status and Ki67 index could independently predict RS. ER, PR status and Ki67 index between RT-PCR and IHC test had remarkable concordance.
Highlights
Breast cancer is recognized as a group of disease with significant heterogeneity, and traditional clinicopathologic factors were no longer enough to meet the needs of prognosis prediction and treatment decision
Retrospective studies from the NSABP B-14 showed that the recurrence score (RS) predicted the likelihood of distant recurrence or breast cancer death in patients treated with endocrine therapy alone [3]
Seven hundred and ninety-five patients (88.7%) were diagnosed to have invasive ductal carcinoma (Table 2), and grade 1, 2, 3 tumors were documented in 17.0%, 57.9% and 25.1% of the patients
Summary
Breast cancer is recognized as a group of disease with significant heterogeneity, and traditional clinicopathologic factors were no longer enough to meet the needs of prognosis prediction and treatment decision. Several multigene assays, based on findings of previous gene expression profiling, were developed and applied into routine practice of estrogen receptor(ER)-positive breast cancer. Retrospective studies from the NSABP B-14 showed that the RS predicted the likelihood of distant recurrence or breast cancer death in patients treated with endocrine therapy alone [3]. The latest prospective validation of RS in TAILORx (Trial Assigning IndividuaLized Options for Treatment) and West German Study Group PlanB trial revealed that among patients with hormone receptor (HR)-positive, human epidermal growth factor receptor (HER2)-negative, node-negative breast cancer and not treated with adjuvant chemotherapy, those with tumors that had a low-risk RS had very low rates of recurrence [11, 12]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call