Michaela T Nguyen1, Alexander Stessin2, Himanshu Nagar2, Timothy M D'Alfonso1, Zhengming Chen3, Tessa Cigler4, Mary Kay Hayes2, Sandra J Shin5. 1. Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY. 2. Department of Radiation Oncology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY. 3. Department of Public Health, Division of Biostatistics, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY. 4. Department of Medical Oncology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY. 5. Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY. Electronic address: sjshin@med.cornell.edu.
Abstract
BACKGROUND: Oncologists have used clinicopathologic features to guide treatment decisions for their breast cancer patients; however, more recently, results of multigene assays are also being considered. A popular assay, Oncotype DX (Genomic Health), stratifies node-negative breast cancer patients into groups that are at low, intermediate, or high risk for distant recurrence and guides decisions about adjuvant chemotherapy utilization. OBJECTIVE: We studied the impact of Oncotype DX recurrence score (ODxRS) compared with that of clinicopathologic features on adjuvant chemotherapy utilization in node-negative breast cancer patients and in node-positive breast cancer patients, and we evaluated whether clinicopathologic features impact the decision for adjuvant chemotherapy utilization in a subset of node-negative breast cancer patients with an intermediate-risk ODxRS. METHODS: A retrospective study from a single academic institution was performed on 425 patients with invasive breast carcinoma. RESULTS: Adjuvant chemotherapy utilization most significantly correlated with a high-risk ODxRS (P < .0001) and, to a lesser degree, patient's age and tumor size. No statistically significant association was found between ODxRS and adjuvant chemotherapy utilization in a subset of patients. In the 156 node-negative breast cancer patients with intermediate-risk ODxRS, high tumor grade most significantly correlated with adjuvant chemotherapy utilization (P < .0001). CONCLUSION: ODxRS, if available, heavily impacts adjuvant chemotherapy utilization and more so than any clinicopathologic factor in node-negative breast cancer patients. Node-negative breast cancer patients in the intermediate-risk group whose tumors were high grade were more likely to receive adjuvant chemotherapy.
BACKGROUND: Oncologists have used clinicopathologic features to guide treatment decisions for their breast cancerpatients; however, more recently, results of multigene assays are also being considered. A popular assay, Oncotype DX (Genomic Health), stratifies node-negative breast cancerpatients into groups that are at low, intermediate, or high risk for distant recurrence and guides decisions about adjuvant chemotherapy utilization. OBJECTIVE: We studied the impact of Oncotype DX recurrence score (ODxRS) compared with that of clinicopathologic features on adjuvant chemotherapy utilization in node-negative breast cancerpatients and in node-positive breast cancerpatients, and we evaluated whether clinicopathologic features impact the decision for adjuvant chemotherapy utilization in a subset of node-negative breast cancerpatients with an intermediate-risk ODxRS. METHODS: A retrospective study from a single academic institution was performed on 425 patients with invasive breast carcinoma. RESULTS: Adjuvant chemotherapy utilization most significantly correlated with a high-risk ODxRS (P < .0001) and, to a lesser degree, patient's age and tumor size. No statistically significant association was found between ODxRS and adjuvant chemotherapy utilization in a subset of patients. In the 156 node-negative breast cancerpatients with intermediate-risk ODxRS, high tumor grade most significantly correlated with adjuvant chemotherapy utilization (P < .0001). CONCLUSION: ODxRS, if available, heavily impacts adjuvant chemotherapy utilization and more so than any clinicopathologic factor in node-negative breast cancerpatients. Node-negative breast cancerpatients in the intermediate-risk group whose tumors were high grade were more likely to receive adjuvant chemotherapy.
Authors: Vanessa B Sheppard; Suzanne C O'Neill; Asma Dilawari; Sara Horton; Fikru A Hirpa; Claudine Isaacs Journal: Clin Breast Cancer Date: 2014-12-01 Impact factor: 3.225
Authors: Rosemary D Cress; Yingjia S Chen; Cyllene R Morris; Helen Chew; Kenneth W Kizer Journal: Cancer Causes Control Date: 2016-04-20 Impact factor: 2.506
Authors: Kelsey E Larson; Stephanie A Valente; Chirag Shah; Rahul D Tendulkar; Sheen Cherian; Jame Abraham; Courtney Yanda; Chao Tu; Jessica Echle; Stephen R Grobmyer Journal: Mol Clin Oncol Date: 2018-08-23
Authors: Irene Zarcos-Pedrinaci; Maximino Redondo; Javier Louro; Francisco Rivas-Ruiz; Teresa Téllez; Diego Pérez; Francisco Medina Cano; Kenza Machan; Laia Domingo; Maria Mar Vernet; Maria Padilla-Ruiz; Xavier Castells; Antonio Rueda; María Sala Journal: Cancer Med Date: 2019-09-24 Impact factor: 4.452