Applying new Magee equations for predicting the Oncotype Dx recurrence score

Sughayer, Maher A.; Alaaraj, Rolla; Alsughayer, Ahmad

doi:10.1007/s12282-018-0860-x

Cited by 12 publications

(9 citation statements)

References 20 publications

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“…Our group was the first to suggest that routine histopathologic data can estimate the oncotype score and also defined a multivariable model in 2008 which was revised in 2013 [5,6]. Since then, there have been several publications that have either validated MEs or defined other similar models [18,19,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. However, the accuracy and simplicity of MEs make it easier to use in routine practice to make confident clinical decisions.…”

Section: Discussionmentioning

confidence: 99%

The healthcare value of the Magee Decision Algorithm™: use of Magee Equations™ and mitosis score to safely forgo molecular testing in breast cancer

et al. 2020

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Magee Equations™ are multivariable models that can estimate oncotype DX® Recurrence Score, and Magee Equation 3 has been shown to have chemopredictive value in the neoadjuvant setting as a standalone test. The current study tests the accuracy of Magee Decision Algorithm™ using a large in-house database. According to the algorithm, if all Magee Equation scores are <18, or 18-25 with a mitosis score of 1, then oncotype testing is not required as the actual oncotype recurrence score is expected to be ≤25 (labeled "do not send"). If all Magee Equation scores are 31 or higher, then also oncotype testing is not required as the actual score is expected to be >25 (also "do not send"). All other cases could be considered for testing (labeled "send"). Of the 2196 ER+, HER2-negative cases sent for oncotype testing, 1538 (70%) were classified as "do not send" and 658 (30%) as "send". The classification accuracy in the "do not send" group was 95.1%. Of the 75 (4.9%) discordant cases (expected score ≤25 by decision algorithm but the actual oncotype score >25), 26 received endocrine therapy alone. None of these 26 patients experienced distant recurrence (average follow-up of 73 months). The Magee Decision Algorithm accurately identifies cases that will not benefit from oncotype testing. Such cases constitute~70% of the routine clinical oncotype requests, an estimated saving of $300,000 per 100 test requests. The occasional discordant cases (expected ≤25, but actual oncotype score >25) appears to have an excellent outcome on endocrine therapy alone.

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Section: Discussionmentioning

confidence: 99%

The healthcare value of the Magee Decision Algorithm™: use of Magee Equations™ and mitosis score to safely forgo molecular testing in breast cancer

et al. 2020

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“…For further validating the clinical benefits of the nomogram, comparisons with established prognostic models of Magee Equations (MEs) 18,19 and Nottingham Prognostic Index (NPI) 20,21 were performed by ROC curve. The testing data was analyzed according to the score system of MEs and NPI.…”

Section: Methodsmentioning

confidence: 99%

“…ME are multivariable models for estimating recurrence score of BC, which has been proved as an effective method and can be calculated using a free online calculator (https://path.upmc.edu/onlineTools/mageeequations.html) to conclude three ME results and one average ME score 18,19 . The average ME score was used in the comparison with nomogram of our study.…”

Section: Methodsmentioning

confidence: 99%

“…It is based on three classic biomarkers of BC (tumor size (S), tumor grade (G), nodal status (N)) and one equation (NPI = 0.2 * S + N + G) to perform scoring calculation for evaluating the prognosis. The results of calculation were analyzed for comparing with the nomogram.ME are multivariable models for estimating recurrence score of BC, which has been proved as an effective method and can be calculated using a free online calculator (https://path.upmc.edu/ onlineTools/mageeequations.html) to conclude three ME results and one average ME score 18,19. The average ME score was used in the comparison with nomogram of our study.F I G U R E 3The Ultrasound-based nomogram for predicting short-disease-free survival (DFS).…”

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confidence: 99%

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Establishment and validation of an ultrasound‐based nomogram with risk stratification for short disease‐free survival in breast cancer

Guo

Dong

Jiang

et al. 2022

J of Clinical Ultrasound

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Purpose This retrospective study aimed to develop and validate an Ultrasound (US)‐based nomogram to predict short disease‐free survival (short‐DFS, less than 120 months DFS) in breast cancer (BC). Methods Nomogram was established based on a training data of 311 BC patients by multivariable logistic regression, and were assessed by discrimination, calibration, and clinical usefulness. Risk stratification was performed by X‐tile. An independent testing data of 200 patients with BC was used for external validation. Results Nine predictors including three US features and six clinical parameters were screened into the nomogram by Lasso (log λ = −3.594) in training data. Better performance was obtained in the training data (C‐index: 0.942) and testing data (C‐index: 0.914). Calibration analysis indicated optimal agreement between nomogram predictions and actual observations (p = 0.67). Decision curve analysis showed a great clinical benefit (Youden index: 0.634). Three risk levels are low‐risk (<184.0), moderate‐risk (184.0–345.3) and high‐risk (>345.3). Our nomograms had larger area under the receiver operating characteristic (ROC) curves compared with Magee Equation and Nottingham Prognostic models (0.942 vs. 0.824, 0.790). Conclusion The US‐based nomogram and the practical score system facilitate individualized prediction of short‐DFS to optimize clinical decisions and improve prognosis in patients with BC.

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“…To date, many predictive methods have been used in individual prediction for survival estimation in BC patients, such as the traditional tumor node metastasis (TNM) staging, Magee Equations (MEs) [ 4 , 5 ], and Nottingham Prognostic Index (NPI) [ 6 , 7 ], which were based on pathology and immunohistochemistry results. Furthermore, some genomic methods, including gene expression profiles [ 8 ], Adjuvant!…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of Ultrasound Characteristics for Disease-Free Survival in Breast Cancer

et al. 2022

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The main objective of this study was to determine the predictive value of US characteristics for disease-free survival (DFS) in BC patients. We retrospectively analyzed the ultrasonic images and clinical data of BC patients who had previously undergone breast surgery at least 10 years before study enrollment and divided them into a case group and a control group according to the cutoff value of 120 months for DFS. Correlation analysis was performed to identify US characteristics as independent predictors for DFS by multivariable logistic regression and Kaplan–Meier survival analysis. A total of 374 patients were collected, including 174 patients in the case group with short-DFS and 200 patients in the control group with long-DFS. Three US characteristics (size on US, mass shape, mass growth orientation) and two clinical factors (axillary lymph node (ALN), molecular subtypes) were identified as independent predictors for DFS (p < 0.05). The ROC curve showed good performance of the multivariate linear regression model with the area under the curve being 0.777. The US characteristics of large size, irregular shape, and nonparallel orientation were significantly associated with short-DFS, which is a promising supplementary for clinicians to optimize clinical decisions and improve prognosis in BC patients.

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Applying new Magee equations for predicting the Oncotype Dx recurrence score

Abstract: Magee equations are user-friendly and can be used to predict the recurrence score in early breast cancer cases.

Cited by 12 publications

References 20 publications

The healthcare value of the Magee Decision Algorithm™: use of Magee Equations™ and mitosis score to safely forgo molecular testing in breast cancer

The healthcare value of the Magee Decision Algorithm™: use of Magee Equations™ and mitosis score to safely forgo molecular testing in breast cancer

Establishment and validation of an ultrasound‐based nomogram with risk stratification for short disease‐free survival in breast cancer

Predictive Value of Ultrasound Characteristics for Disease-Free Survival in Breast Cancer

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