Impact of the 21-gene recurrence score on outcome in patients with invasive lobular carcinoma of the breast

Kizy, Scott; Huang, Jing; Marmor, Schelomo; Tuttle, Todd M.; Hui, Jane Yuet Ching

doi:10.1007/s10549-017-4355-9

Cited by 56 publications

(60 citation statements)

References 21 publications

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“…14,15 In fact, recent data has suggested that ORS may be less useful in predicting response to adjuvant chemotherapy in patients with invasive lobular carcinoma. 16 These data raise the question whether ORS should be interpreted with caution in invasive carcinomas with favorable histology.…”

Section: Discussionmentioning

confidence: 99%

“…There are several multigene assays used to predict the risk of distant recurrence and the potential benefit of systemic therapy in lymph node-negative, estrogen receptor positive, human epidermal growth factor receptor-2 (HER2)-negative invasive carcinomas. 1 Oncotype Dx ® measures the expression of 21 genes to calculate a quantitative recurrence score (ORS) that is stratified into 3 categories: low risk (0-10), intermediate risk (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), and high risk (≥26) based on the prospective TAILORx trial. 2 Oncotype Dx ® has been incorporated into the AJCC 2017 staging criteria for estrogen receptor positive, HER2-negative, and lymph node-negative invasive carcinomas.…”

Section: Introductionmentioning

confidence: 99%

“…Invasive carcinomas were graded according to the Elston and Ellis modification of the Nottingham grading system based on the extent of tubule formation, nuclear grade, and mitotic count (grade I: total score 3-5, grade II total score 6 or 7, and grade III total score 8 or 9). For logistic regression, oncotype risk categories were dichotomized into low (0-10) or intermediate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) and high risk (≥26).…”

Section: Introductionmentioning

confidence: 99%

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Breast cancer histopathology is predictive of low-risk Oncotype Dx recurrence score

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Breast cancer histopathology is predictive of low-risk Oncotype Dx recurrence score

et al. 2018

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“…Lobular BC was associated with low and intermediate RS (P < .001) ( Table 2). Low RS (range, 0-11), intermediate RS (range, [12][13][14][15][16][17][18][19][20][21][22][23][24][25], and high RS (range, 26-100) Oncotype DX categories were observed in 20%, 72%, and 8% lobular BCs, respectively. The prevalence of high RS results was 3-fold lower in lobular BC compared with nonlobular BC (8% vs 24%; P < .001).…”

Section: Lower Rs In Lobular Bcmentioning

confidence: 98%

Differential impact of prognostic parameters in hormone receptor–positive lobular breast cancer

Christgen

Gluz

Harbeck

et al. 2020

Cancer

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BACKGROUND: Invasive lobular breast cancer (BC) is the second most common BC subtype. Prognostic parameters (tumor classification, lymph node status, histologic grade, Oncotype DX recurrence score [RS], progesterone receptor status, and Ki67 index) were retrospectively studied in a large, prospective clinical trial encompassing 2585 patients who had hormone receptor-positive early BC (the West German Study Group PlanB trial). METHODS: BCs were centrally reviewed and classified as lobular (n = 353; 14%) or nonlobular (n = 2232; 86%). The median follow-up was 60 months. Five-year disease-free survival (DFS) estimates were obtained using the Kaplan-Meier method. Prognostic parameters were evaluated using Cox proportional hazard models. RESULTS: Lobular BC was associated with higher tumor classification, higher lymph node status, lower histologic grade, lower Ki67 index, and low or intermediate RS. The prevalence of high RS (RS range, 26-100) was 3-fold lower in patients who had lobular BC compared with those who had nonlobular BC (8% vs 24%; P < .001). However, 5-year DFS estimates for lobular and nonlobular BC were similar (92.1% and 92.3%, respectively; P = .673). In multivariate analyses, prognostic parameters for DFS in lobular BC included grade 3 (hazard ratio, 5.06; 95% CI, 1.91-13.39) and a pathologic lymph node status (pN) of pN3 (

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“…It is probable that applying a selective pressure such as chemotherapy could cause the emergence of treatment-resistant clones [43]. As the use of chemotherapy is disputed for lobular breast cancer [44], sub-analyses of women with lobular breast cancer was performed. The data showed wide confidence intervals, indicating limit power and therefore no meaningful conclusions could be drawn.…”

Section: Discussionmentioning

confidence: 99%

Invasive Breast Cancer Over Four Decades Reveals Persisting Poor Metastatic Outcomes In Treatment Resistant Subgroup – The “ATRESS” Phenomenon

Jurrius

Green

Garmo

et al. 2019

European Journal of Surgical Oncology

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Background: Major advances in breast cancer treatment have led to a reducuction in mortality. However, there are still women who are not cured. We hypothesize there is a subgroup of women with treatmentresistant cancers causing early death. Methods: Between 1975 and 2006, 5392 women with invasive breast cancer underwent surgery at Guy's Hospital, London. Data on patient demographics, tumour characteristics, treatment regimens, local recurrence, secondary metastasis, and death were prospectively recorded. We considered four time periods (1975e1982, 1983e1990, 1991e1998, 1999e2006). Risks and time to event analysis were performed with Cox proportional hazards model and Kaplan-Meier estimation. Results: Unadjusted hazard ratios for developing metastasis and overall mortality relative to the 1975 e1982 cohort decreased steadily to 0.23 and 0.63, respectively in 1999e2006. However, metastasis-free interval shortened, with the proportion of women developing metastasis 5 years increasing from 73.9% to 83.0%. Furthermore, median post-metastatic survival decreased from 1.49 years to 0.94 years. Applying our risk criteria identified the presence of ±200 patients in each cohort who developed metastasis early and died within a much shorter time frame. Conclusions: Advances in treatment have decreased the risk of metastasis and improved survival in women with invasive breast cancer over the last 40 years. Despite this, a subpopulation with shorter metastasis-free and post-metastatic survival who are unresponsive to available treatment remains. This may be due to the ATRESS phenomenon (adjuvant therapy-related shortening of survival) secondary to preselection inherent in adjuvant therapy, successful treatment of less malignant tumour cells and treatment-induced resistance in the remaining tumour clones.

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Impact of the 21-gene recurrence score on outcome in patients with invasive lobular carcinoma of the breast

Cited by 56 publications

References 21 publications

Breast cancer histopathology is predictive of low-risk Oncotype Dx recurrence score

Breast cancer histopathology is predictive of low-risk Oncotype Dx recurrence score

Differential impact of prognostic parameters in hormone receptor–positive lobular breast cancer

Invasive Breast Cancer Over Four Decades Reveals Persisting Poor Metastatic Outcomes In Treatment Resistant Subgroup – The “ATRESS” Phenomenon

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