Association of Body Mass Index With 21-Gene Recurrence Score Among Women With Estrogen Receptor–Positive, <i>ERBB2</i>–Negative Breast Cancer

Lee, Janghee; Kim, Hakyoung; Bae, Soong June; Ji, Jung Hwan; Lee, Jong Won; Son, Byung Ho; Lee, Sae Byul; Ahn, Sung Gwe

doi:10.1001/jamanetworkopen.2022.43935

Cited by 6 publications

(6 citation statements)

References 35 publications

(63 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To begin, our study is clearly a retrospective cohort study that is inevitably biased by patients’ selection in the SEER database. Second, there is a lack of some proven prognostic factors such as BRCA1/2 gene ( 43 , 44 ), body mass index (BMI) ( 45 , 46 ) and family history ( 47 ) in the SEER database, all of which have been found to be highly linked to poorer results for patients diagnosed with breast cancer. Third, we cannot operate further research on the roles of systematic treatments in YBC patients with RLNM, for the reason that detailed information on specific chemotherapy regimens and endocrine therapy was not accessible in the SEER database.…”

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting overall survival of breast cancer with regional lymph node metastasis in young women

Sun,

Huang,

Chen

et al. 2024

Transl Cancer Res

View full text Add to dashboard Cite

Background Young breast cancer (YBC) patients demonstrate a heightened propensity for regional lymph node metastasis (RLNM) in contrast to cohorts across varying age demographics. The aim of our study was to identify clinicopathologic prognostic variables in YBC patients with RLNM and construct a practical and reliable nomogram for the prediction of overall survival (OS) using the Surveillance, Epidemiology, and End Results (SEER) database. Methods Young individuals (≤40 years) with a diagnosis of breast cancer with RLNM were recognized from the SEER database between 2010 and 2015, and further randomly split into two cohorts: the training set (n=4,497) and the validation set (n=1,927). We first performed univariate and multivariate Cox regression analyses to confirm independent survival predictors of OS. A novel prognostic nomogram was developed and evaluated using Harrell’s concordance index (C-index), receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). To make a clear distinction between high- and low-risk patients in terms of patient survival, Kaplan-Meier survival curves were assessed using the log-rank test. Results Nine risk factors were found as independent prognostic variables in predicting OS, including race, grade, histology, surgery, radiation, molecular subtype, American Joint Committee on Cancer (AJCC) stage 7 th edition, T stage, and N stage. The C-index values of our nomogram were 0.786 [95% confidence interval (CI): 0.767–0.805] and 0.791 (95% CI: 0.760–0.822) in our training and validation groups, respectively. The ROC curves demonstrated sufficient discriminating ability, while the predicted and real survival rates were fairly consistent, as shown by the calibration plots. The prediction model had a higher net benefit and acceptable clinical value, as shown by the DCA curves. Conclusions In YBC patients with RLNM, we successfully established a unique nomogram to forecast the 2-, 3-, and 5-year OS. Clinicians may utilize this nomogram to pinpoint patients at higher risk and provide them with appropriate customized therapies.

show abstract

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting overall survival of breast cancer with regional lymph node metastasis in young women

Sun,

Huang,

Chen

et al. 2024

Transl Cancer Res

View full text Add to dashboard Cite

show abstract

“…Since the 21-gene RS test (Oncotype DX) became clinically available, both hospitals have been conducting the test only on patients who met the indications at that time and agreed to undergo the test . Ultimately, we selected patients who had an available 21-gene RS assay result . Clinical information on patients and pathological data on breast cancer were obtained through a comprehensive review of medical records.…”

Section: Methodsmentioning

confidence: 99%

“… 18 Ultimately, we selected patients who had an available 21-gene RS assay result. 19 Clinical information on patients and pathological data on breast cancer were obtained through a comprehensive review of medical records. Patients who had received neoadjuvant chemotherapy were excluded from the study since they did not undergo 21-gene RS testing.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Ki-67, 21-Gene Recurrence Score, Endocrine Resistance, and Survival in Patients With Breast Cancer

Lee,

Bae

et al. 2023

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

ImportanceBoth high 21-gene recurrence score (RS) and high Ki-67 level are poor prognostic factors in patients with estrogen receptor (ER)–positive ERBB2-negative (ER+/ERBB−) breast cancer; however, a discrepancy between the 2 has been noted. Survival differences according to these 2 biomarkers are not well known.ObjectiveTo assess the associations between RS and Ki-67 expression and between Ki-67 expression and recurrence-free survival in patients with ER+/ERBB− breast cancer with low RS.Design, Setting, and ParticipantsThis cohort study included women treated for ER+/ERBB2− breast cancer who underwent the 21-gene RS test from March 2010 to December 2020 in 2 hospitals in Korea.ExposuresRecurrence score and Ki-67 level.Main Outcomes and MeasuresA Cox proportional hazards regression model was used to examine the association of Ki-67 with recurrence-free survival (RFS), while a binary logistic regression model was used to examine the association between Ki-67 and secondary endocrine resistance. High Ki-67 expression was defined as 20% or greater, and low genomic risk as an RS of 25 or less. Secondary endocrine resistance was defined as breast cancer recurrence that occurred after at least 2 years of endocrine therapy and during or within the first year after completing 5 years of adjuvant endocrine therapy.ResultsA total of 2295 female patients were included (mean [SD] age, 49.8 [9.3] years), of whom 1948 (84.9%) were in the low genomic risk group and 1425 (62.1%) had low Ki-67 level. The median follow-up period was 40 months (range, 0-140 months). The RS and Ki-67 level had a moderate correlation (R = 0.455; P &lt; .001). Of the patients with low Ki-67 level, 1341 (94.1%) had low RS, whereas 607 of 870 patients with high Ki-67 level (69.8%) had low RS. In patients with low RS, the RFS differed significantly according to Ki-67 level (low Ki-67, 98.5% vs high Ki-67, 96.5%; P = .002). Among the 1807 patients with low genomic risk who did not receive chemotherapy, high Ki-67 level was independently associated with recurrence (hazard ratio, 2.51; 95% CI, 1.27-4.96; P = .008). Recurrence after 3 years differed significantly according to Ki-67 level (low Ki-67, 98.7% vs high Ki-67, 95.7%; P = .003), whereas recurrence within 3 years did not differ (low Ki-67, 99.3% vs high Ki-67, 99.3%; P = .90). In addition, Ki-67 was associated with secondary endocrine resistance in patients with low RS who did not receive chemotherapy (odds ratio, 2.49; 95% CI, 1.13-5.50; P = .02).Conclusions and RelevanceIn this cohort study of patients with ER+/ERBB2− breast cancer, a moderate correlation was observed between Ki-67 and RS, and high Ki-67 level in patients with low genomic risk was associated with increased risk of secondary endocrine resistance.

show abstract

“…High body mass index (BMI), insulin resistance, increased levels of leptin and aromatase enzymes, and inflammation of breast adipose tissue are believed to contribute to obesity-related post-menopausal breast cancer [13]. In a recent study, high BMI, a widely used index of obesity, was an independent factor associated with a high 21-gene recurrence score in estrogen receptor (ER)-positive, ERBB2-negative young (≤45 years) breast cancer patients [14]. Several studies have provided compelling evidence to demonstrate an increased risk of breast cancer among diabetic women as well as higher mortality and diminished quality of life [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Obesity Associated with Prediabetes Increases the Risk of Breast Cancer Development and Progression—A Study on an Obese Rat Model with Impaired Glucose Tolerance

Kallamadi,

Esari,

Addi

et al. 2023

IJMS

View full text Add to dashboard Cite

Patients with comorbidities of obesity and diabetes are recognized to be at high risk of breast cancer development and face worse breast cancer outcomes. Though several reports showed the reinforced link between obesity, diabetes, and prediabetes with breast cancer, the underlying molecular mechanisms are still unknown. The present study aimed to investigate the underlying molecular link between increased risks of breast cancer due to coincident diabetes or obesity using a spontaneous obese rat model with impaired glucose tolerance (WNIN/GR-Ob rat). A single dose of solubilized DMBA suspension (40 mg/kg body weight) was orally administered to the animals at the age of 60 days to induce breast tumors. The tumor incidence, latency period, tumor frequency, and tumor volume were measured. Histology, immunohistochemistry, and immunoblotting were performed to evaluate the tumor morphology and expression levels of signal molecules. The development of mammary tumors in GR-Ob rats was characterized by early onset and shorter latency periods compared to control lean rats. While 62% of obese rats developed breast tumors, tumor development in lean rats was only 21%. Overexpression of ER, PR, Ki67, and p53 markers was observed in tumor tissues of obese rats in comparison with lean rats. The levels of the hallmarks of cell proliferation and angiogenesis involved in IGF-1/PI3K/Akt/GSK3β/β-catenin signaling pathway molecules were upregulated in obese rat breast tumors compared to lean rats. Furthermore, obesity with prediabetes is associated with changes in IGF-1 signaling and acts on PI3K/Akt/GSK3β/β-catenin signaling, which results in rapid cell proliferation and development of breast tumors in obese rats than the lean rats. These results indicate that tumor onset and development were faster in spontaneous obese rat models with impaired glucose tolerance than in their lean counterparts.

show abstract

Association of Body Mass Index With 21-Gene Recurrence Score Among Women With Estrogen Receptor–Positive, ERBB2–Negative Breast Cancer

Cited by 6 publications

References 35 publications

A nomogram for predicting overall survival of breast cancer with regional lymph node metastasis in young women

A nomogram for predicting overall survival of breast cancer with regional lymph node metastasis in young women

Ki-67, 21-Gene Recurrence Score, Endocrine Resistance, and Survival in Patients With Breast Cancer

Obesity Associated with Prediabetes Increases the Risk of Breast Cancer Development and Progression—A Study on an Obese Rat Model with Impaired Glucose Tolerance

Contact Info

Product

Resources

About