Abstract

Breast cancer (BRCA) is the most common cancer among women and is the second leading cause of cancer death in women. In this study, we developed a 9‐gene prognostic signature to predict the prognosis of patients with BRCA. GSE20685, GSE42568, GSE20711, and GSE88770 were used as training sets. The Kaplan–Meier plot was constructed to assess survival differences and log‐rank test was performed to evaluate the statistical significance. The overall survival (OS) of patients in the low‐risk group was significantly higher than that in the high‐risk group. ROC analysis indicated that this 9‐gene signature shows good diagnostic efficiency both in OS and disease‐free survival (DFS). The 9‐gene signature was further validated through GSE16446, GSE7390, and TCGA‐BRCA datasets. We also established a nomogram that integrates clinicopathological features and 9‐gene signature. The analysis of the calibration plot showed that the nomogram has good prognostic performance. More convincingly, real‐time reverse transcription‐polymerase chain reaction (RT‐PCR) results indicated that the protective prognostic factors in BRCA patients were downregulated, whereas the dangerous prognostic factors were upregulated. The innovation of this article is not only constructing a prognostic gene signature, but also combining with clinical information to further establish a nomogram to better predict the survival probability of patients. It is worth mentioning that this signature also does not depend on other clinical factors or variables.

Highlights

  • Breast cancer (BRCA) is the most common cancer among women worldwide and results in the second leading cause of woman cancer death

  • receiver operating characteristic (ROC) analysis showed that this 9-gene signature showed good diagnostic efficiency both in overall survival(OS) and disease free survival(DFS)

  • This study has developed a reliable 9-gene prognostic signature, which is of great value in predicting the prognosis of BRCA and will help to make personalized treatment decisions for patients at different risk score

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Summary

Introduction

Breast cancer (BRCA) is the most common cancer among women worldwide and results in the second leading cause of woman cancer death. Gallen International Breast Cancer Conference, breast cancer was classified into Luminal A, Luminal B, HER2 positive and triple negative breast cancer (TNBC) four major parts based on the detection results of ER, PR, HER2 and Ki67 [2] Among these four molecular types, Luminal A breast cancer is the most common molecular subtype. The results of research by Ihemelandu et al showed that Luminal A type accounts for 50% of breast cancer patients, Luminal B, HER2 positive and TNBC types accounted for 14.1%, 12.7%, and 23.2%, respectively[3]. These subtypes show different histopathological characteristics and therapeutic sensitivities. The prognosis of advanced breast cancer is still not optimistic[8]

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