Oncotype DX score, menopausal status and body mass index

Picardo, Sarah; Sui, Jing; Greally, Megan; Woulfe, Bernie; Prior, Lisa; Corrigan, Lynda; O’Leary, Connor; Mullally, William J.; Walshe, Janice; McCaffrey, John; O’Connor, Miriam; O’Mahony, Deirdre; Coate, Linda; Gupta, Rajnish K.; O’Reilly, Seamus

doi:10.1093/annonc/mdx362.043

Cited by 3 publications

(3 citation statements)

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“…Less precision in our designation of metabolic syndrome in combination with low rates of obesity and metabolic syndrome overall in this cohort could account for differences in our findings. A similar analysis of Oncotype RS in a cohort of 269 patients with breast cancer also found that post-menopausal patients had higher RS and lower PR expression than pre-menopausal patients, which is consistent with the higher rates of PR negativity seen in our post-menopausal cohort [23]. However, they found that higher BMI was associated with higher RS, whereas we found the opposite.…”

Section: Discussionsupporting

confidence: 89%

Obesity and menopausal status impact the features and molecular phenotype of invasive lobular breast cancer

Rothschild

Abel

Patterson

et al. 2021

Breast Cancer Res Treat

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Purpose We investigated the relationship between obesity, menopausal status, and invasive lobular carcinoma (ILC), the second most common histological subtype of breast cancer. Specifically, we evaluated the association between body mass index (BMI), metabolic syndrome, the 21-gene Oncotype Recurrence Score (Oncotype RS), and pathological features in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor-2-negative ILC. Methods The study cohort included 491 patients from a prospectively maintained institutional database consisting of patients with stage I-III, HR-positive ILC who underwent surgical treatment between 1996 and 2019. Results Contrary to our expectations, we found that lower BMI was significantly associated with having higher Oncotype RS (18.9% versus 4.8%, p = 0.028) in post-menopausal patients, but was not related to tumor characteristics in pre-menopausal patients. Multivariate network analyses suggested a strong relationship between post-menopausal status itself and tumor characteristics, with lesser influence of BMI. Conclusion These findings provide further insight into the recently appreciated heterogeneity within ILC and support the need for further investigation into the drivers of this disease and tailored treatment strategies.

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Section: Discussionsupporting

confidence: 89%

Obesity and menopausal status impact the features and molecular phenotype of invasive lobular breast cancer

Rothschild

Abel

Patterson

et al. 2021

Breast Cancer Res Treat

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“…Thus, a woman over 50 is less likely to have intermediate RS than low RS, but she is more likely to have high RS than low RS. For the menopausal status, the association was not significant with RS, as showed by several studies [33,36], with the exception of the study by Picardo and al [34]. Similar to age, the interpretation of the association between menopausal status and RS remains challenging.…”

Section: Discussionmentioning

confidence: 89%

“…In regard to the BMI, our results are in agreement with various studies that did not show an association between RS and BMI [ 32 , 33 ]. However, one study has found RS to be higher in overweight patients with node-negative BC [ 34 ]. In addition, in our study, the variable "age" adjusted for other covariates was not significantly associated with RS, which seems to be consistent with several studies [ 17 , 19 , 20 ], even though others have reported an association [ 18 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Identifying Clinicopathological Factors Associated with Oncotype DX® 21-Gene Recurrence Score: A Real-World Retrospective Cohort Study of Breast Cancer Patients in Quebec City, Canada

Gagnet

Diorio

Provencher

et al. 2021

JPM

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Gene expression profiling tests such as the Oncotype DX (ODX) 21-gene recurrence score (RS) assay is increasingly used in clinical practice to predict the risk of recurrence and support treatment planning for early-stage breast cancer (BC). However, this test has some disadvantages such as a high cost and a long turnaround time to get results, which may lead to disparities in access. We aim to identify clinicopathological factors associated with ODX RS in women with early-stage BC. We conducted a retrospective cohort study of women identified in the medical database of the Deschênes-Fabia Breast Disease Center of Quebec City University, Canada. Our sample consists of 425 women diagnosed with early-stage BC who have obtained an ODX RS between January 2011 and April 2015. The ODX RS has been categorized into three levels as originally defined: low (0–17), intermediate (18–30), and high (>30). The mean RS was 17.8 (SD = 9.2). Univariate analyses and multinomial logistic regressions were performed to identify factors associated with intermediate and high RS compared with low RS. A total of 237 (55.8%) patients had low RS, 148 (34.8%) had intermediate RS, and 40 (9.4%) had high RS. Women with progesterone receptor (PR)-negative (ORs ranging from 3.51 to 10.34) and histologic grade II (ORs ranging from 3.16 to 23.04) tumors were consistently more likely to have intermediate or high RS than low RS. Similar patterns of associations were observed when the RS was categorised using redefined thresholds from (i.e., from the TAILORx study or dichotomized). This study provides evidence suggesting that histologic grade and PR status are predictive factors for intermediate or high RS in women with early-stage BC. If these results are confirmed in future studies, considering these clinicopathological factors could spare women the need to get such a test before the beginning of a possible adjuvant therapy. This option could be considered in settings where the cost of testing is an issue.

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Obesity and Breast Cancer Metastasis across Genomic Subtypes

Olsson

Walens

Hamilton

et al. 2022

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Obese women have higher risk of aggressive breast tumors and distant metastasis. However, obesity has rarely been assessed in association with metastasis in diverse populations. Methods: In the Carolina Breast Cancer Study Phase 3 (2008-2013), waist-to-hip ratio (WHR), body mass index (BMI), and molecular subtype (PAM50 Risk-of-Recurrence [ROR] score) were assessed. Obesity measures were evaluated in association with metastasis within five years of diagnosis, overall and stratified by race and ROR score. Absolute risk of metastasis and risk differences between strata were calculated using the Kaplan-Meier estimator, adjusted for age, grade, stage, race, and ER status. Relative frequency of metastatic site and multiplicity were estimated in association with obesity using generalized linear models. Results: High-WHR was associated with higher risk of metastasis [5-year risk difference, RD (95% CI): 4.3% (2.2, 6.5)]. It was also associated with multiple metastases and metastases at all sites except brain. The 5-year risk of metastasis differed by race (11.2% and 6.9% in Black and non-Black, respectively) and ROR score (19.5% vs. 6.6% in high vs. low-to-intermediate ROR-PT). Non-Black women and those with low-to-intermediate ROR scores had similar risk in high- and low-WHR strata. However, among Black women and those with high ROR, risk of metastasis was elevated among high-WHR (RDBlack/non-Black=4.6%, RDHigh/Low-Int=3.1%). Patterns of metastasis were similar by BMI. Conclusions: WHR is associated with metastatic risk, particularly among Black women and those with high-risk tumors. Impact: Understanding how risk factors for metastasis interact may help in tailoring care plans and surveillance among breast cancer patients.

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Oncotype DX score, menopausal status and body mass index

Cited by 3 publications

References 0 publications

Obesity and menopausal status impact the features and molecular phenotype of invasive lobular breast cancer

Obesity and menopausal status impact the features and molecular phenotype of invasive lobular breast cancer

Identifying Clinicopathological Factors Associated with Oncotype DX® 21-Gene Recurrence Score: A Real-World Retrospective Cohort Study of Breast Cancer Patients in Quebec City, Canada

Obesity and Breast Cancer Metastasis across Genomic Subtypes

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