Comparison of Oncotype DX and Mammostrat risk estimations and correlations with histologic tumor features in low-grade, estrogen receptor-positive invasive breast carcinomas

Ács, Géza; Kiluk, John V.; Loftus, Loretta; Laronga, Christine

doi:10.1038/modpathol.2013.88

Cited by 26 publications

(15 citation statements)

References 40 publications

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“…However, the disadvantages of the aforementioned molecular testing are the relatively high cost and the far mostly unknown influence of tumour heterogeneity. More specifically, intermingled non-tumour tissue may have a profound influence on the test results [50]. …”

Section: Discussion Of Current Literaturementioning

confidence: 99%

The prognostic value of tumour–stroma ratio in primary breast cancer with special attention to triple-negative tumours: a review

Kramer

Vangangelt

Pelt

et al. 2018

Breast Cancer Res Treat

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Purpose There is a strong need to improve the prognostication of breast cancer patients in order to prevent over- and undertreatment, especially when considering adjuvant chemotherapy. Tumour stroma characteristics might be valuable in predicting disease progression. Methods Studies regarding the prognostic value of tumour–stroma ratio (TSR) in breast cancer are evaluated. Results A high stromal content is related to a relatively poor prognosis. The most pronounced prognostic effect of this parameter seems to be observed in the triple-negative breast cancer (TNBC) subtype. Conclusions TSR assessment might represent a simple, fast and reproducible prognostic factor at no extra costs, and could possibly be incorporated into routine pathological diagnostics. Despite these advantages, a robust clinical validation of this parameter has yet to be established in prospective studies. Electronic supplementary material The online version of this article (10.1007/s10549-018-4987-4) contains supplementary material, which is available to authorized users.

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Section: Discussion Of Current Literaturementioning

confidence: 99%

The prognostic value of tumour–stroma ratio in primary breast cancer with special attention to triple-negative tumours: a review

Kramer

Vangangelt

Pelt

et al. 2018

Breast Cancer Res Treat

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“…However these gene expression tests tend to be expensive, tissue destructive and require physical shipping of tissue blocks for the test to be done. Interestingly BCa grade in these tumors has been shown to be highly correlated with the ODX risk score123. Unfortunately studies have shown that Bloom Richarsdon (BR) grade determined by pathologists can be highly variable4.…”

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confidence: 99%

Automated Tubule Nuclei Quantification and Correlation with Oncotype DX risk categories in ER+ Breast Cancer Whole Slide Images

Romo-Bucheli

Janowczyk

Gilmore

et al. 2016

Sci Rep

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Early stage estrogen receptor positive (ER+) breast cancer (BCa) treatment is based on the presumed aggressiveness and likelihood of cancer recurrence. Oncotype DX (ODX) and other gene expression tests have allowed for distinguishing the more aggressive ER+ BCa requiring adjuvant chemotherapy from the less aggressive cancers benefiting from hormonal therapy alone. However these tests are expensive, tissue destructive and require specialized facilities. Interestingly BCa grade has been shown to be correlated with the ODX risk score. Unfortunately Bloom-Richardson (BR) grade determined by pathologists can be variable. A constituent category in BR grading is tubule formation. This study aims to develop a deep learning classifier to automatically identify tubule nuclei from whole slide images (WSI) of ER+ BCa, the hypothesis being that the ratio of tubule nuclei to overall number of nuclei (a tubule formation indicator - TFI) correlates with the corresponding ODX risk categories. This correlation was assessed in 7513 fields extracted from 174 WSI. The results suggests that low ODX/BR cases have a larger TFI than high ODX/BR cases (p < 0.01). The low ODX/BR cases also presented a larger TFI than that obtained for the rest of cases (p < 0.05). Finally, the high ODX/BR cases have a significantly smaller TFI than that obtained for the rest of cases (p < 0.01).

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“…This may be explained by observations that PREDICT underestimates breast cancer mortality in women with small ER-positive tumours and overestimates mortality in women with larger ER-positive tumours [17]. In addition, the presence of mitotically active tumour stroma and/or inflammatory cells associated with low-grade invasive breast carcinomas may contribute to higher RS scores generated by ODX testing in comparison to recurrence scores generated by clinicopathological scoring systems [18].…”

Section: Discussionmentioning

confidence: 99%

The Utility of Oncotype DX for Adjuvant Chemotherapy Treatment Decisions in Estrogen Receptor-positive, Human Epidermal Growth Factor Receptor 2-negative, Node-negative Breast Cancer

Rizki¹,

Hillyar²,

Abbassi³

et al. 2020

Cureus

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Breast cancer is the most common cancer diagnosis in the UK. Recently, there has been a reduction in breast cancer-specific mortality and recurrence attributed, in part, to the delivery of adjuvant chemotherapy. The National Institute for Health and Care Excellence (NICE) recommends the use of genetic profiling with Oncotype DX (ODX) to guide decisions to offer adjuvant chemotherapy after surgery in intermediate-risk early breast cancer patients. This study aimed to evaluate the utility of ODX testing in routine clinical practice in a National Health Service (NHS) hospital. Methods Consecutive early breast cancer patients, identified through the multidisciplinary team (MDT) records, treated in our institution over 12 months (October 2017-September 2018) were included. PREDICT and Nottingham prognostic index (NPI) scores (from online clinicopathological recurrence risk tools) were calculated for each patient, and ODX data obtained through Genomic Health, Inc. (Redwood City, California). Patients were divided into two groups, those that underwent ODX testing (ODX group) and those that did not (non-ODX group). Descriptive statistics were used to analyse patient and tumour characteristics. The Gaussian distribution of each data set was assessed using the Anderson-Darling test. For comparisons between patient groups, the non-parametric equivalent of the two-tailed t-test (Mann-Whitney) was used. Dichotomous variables (e.g. chemotherapy decisions) were compared using chi-squared tests. Results One-hundred thirty-three patients (mean age 62 years) treated for 152 early breast cancers, were included in the final analysis. Breast cancers in the ODX group were of greater median tumour size (24 vs 16 mm; P<0.0001) and higher median tumour grade (3 vs 2; P<0.0001). PREDICT scores (3 vs 1, P<0.0001) and NPI scores (3.40 vs 2.30, P<0.0001) for the ODX group were also significantly higher than the non-ODX group. A greater proportion of patients were offered chemotherapy in the ODX group (39.9% vs 6.9%, P<0.001). However, for the PREDICTcalculated intermediate-risk patients, ODX testing resulted in a lower proportion of patients being offered chemotherapy compared to the intermediate-risk patients who were not 1 2 3 3

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Comparison of Oncotype DX and Mammostrat risk estimations and correlations with histologic tumor features in low-grade, estrogen receptor-positive invasive breast carcinomas

Cited by 26 publications

References 40 publications

The prognostic value of tumour–stroma ratio in primary breast cancer with special attention to triple-negative tumours: a review

The prognostic value of tumour–stroma ratio in primary breast cancer with special attention to triple-negative tumours: a review

Automated Tubule Nuclei Quantification and Correlation with Oncotype DX risk categories in ER+ Breast Cancer Whole Slide Images

The Utility of Oncotype DX for Adjuvant Chemotherapy Treatment Decisions in Estrogen Receptor-positive, Human Epidermal Growth Factor Receptor 2-negative, Node-negative Breast Cancer

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