Can mammographic and sonographic imaging features predict the Oncotype DX™ recurrence score in T1 and T2, hormone receptor positive, HER2 negative and axillary lymph node negative breast cancers?

Abstract

To determine whether mammographic or sonographic features can predict the Oncotype DX™ recurrence scores (RS) in patients with TI-II, hormone receptor (HR) positive, HER2/neu negative and node negative breast cancers. Institutional board review was obtained and informed consent was waived for this retrospective study. Seventy-eight patients with stage I-II invasive breast cancer that was HR positive, HER2 negative, and lymph node negative for whom mammographic and or sonographic imaging and Oncotype DX™ assay scores were available were included in the study Four breast dedicated radiologists blinded to the RS retrospectively described the lesions according to BI-RADS lexicon descriptors. Multivariable logistic regression was used to test for significant independent predictors of low (<18) versus intermediate to high range (≥18). Two imaging features reached statistical significance in predicting low from intermediate or high risk RS: pleomorphic microcalcifications within a mass (P = 0.017); OR 8.37, 95 % CI (1.47-47.79) on mammography and posterior acoustic enhancement in a mass on ultrasound (P = 0.048); OR 4.35, 95 % CI (1.01-18.73) on multivariable logistic regression. A mass with pleomorphic microcalcifications on mammography or the presence of posterior acoustic enhancement on ultrasound may predict an intermediate to high RS as determined by the Oncotype DX(TM) assay in patients with stage I-II HR positive, HER2 negative, and lymph node negative invasive breast cancer.

Qualitative Radiogenomics: Association between Oncotype DX Test Recurrence Score and BI-RADS Mammographic and Breast MR Imaging Features

“…This proposed mechanism of tumor growth was also discussed by Dialani et al, who noted a higher ODxRS among masses with an oval shape (which is often considered a more benign morphology at mammography). Yepes et al did not observe an association between mass margins and ODxRS, although a smaller sample size for their mass margins may have reduced their power to detect a difference (18). We also found fine linear branching calcification morphology to be independently associated with a higher ODxRS.…”

“…The majority of previous studies that explored the association between breast imaging phenotypes and gene expression profiles in the context of recurrence risk focused on quantitative magnetic resonance (MR) imaging features (13)(14)(15)(16). Two prior studies assessed the association between qualitative Breast Imaging Reporting and Data System (BI-RADS) mammographic and MR imaging descriptors used in daily clinical practice and Oncotype DX, a molecular assay of recurrence risk, in patients with ERpositive cancers (17,18). Prior singleinstitution studies found no relationship between mammographic breast density or nonmass enhancement (NME) at MR imaging and recurrence risk; however, differences in cohort selection, smaller sample sizes for various imaging features, and failure to control for potential confounders such as age, body mass index, menopausal status, or prior history of breast cancer may have influenced these investigators' results.…”

“…Oncotype DX Test Recurrence Score Women identified for this study underwent Oncotype DX tumor profiling at the time of diagnosis. The Oncotype DX assay calculates a woman's risk of distant disease recurrence in the next 10 years and categorizes it into three risk levels: low (score ,18), intermediate (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and high (31) (8). These three categories correspond to an estimated Oncotype DX test recurrence score (ODxRS) of 6.8%, 14.3%, and 30.5%, respectively.…”

Apparent diffusion coefficient in estrogen receptor‐positive and lymph node‐negative invasive breast cancers at 3.0T DW‐MRI: A potential predictor for an oncotype Dx test recurrence score

“…Correlating genomic information with image findings is a new field of research, and the overlap between imaging features and genomic characteristics in breast cancer is not well established. The ability to estimate the likelihood of recurrence on the basis of molecular profile and imaging findings could become an important noninvasive tool for stratifying patients according to prognosis, allowing clinicians to make personalized tailored treatment decisions for an individual patient . Our goal was to measure lesion ADC value at 3T and to assess correlation with ODxRS scores.…”

“…The ability to estimate the likelihood of recurrence on the basis of molecular profile and imaging findings could become an important noninvasive tool for stratifying patients according to prognosis, allowing clinicians to make personalized tailored treatment decisions for an individual patient. [16][17][18] Our goal was to measure lesion ADC value at 3T and to assess correlation with ODxRS scores.…”