21-Gene Recurrence Score Assay Could Not Predict Benefit of Post-mastectomy Radiotherapy in T1-2 N1mic ER-Positive HER2-Negative Breast Cancer
Introduction: It is still controversial whether post-mastectomy radiotherapy (PMRT) is necessary for women with T1-2 N1mic ER-positive HER2-negative breast cancer. The 21-gene recurrence score (RS) assay has been validated in T1-2 N1 breast cancer to be prognostic of locoregional recurrence (LRR) an...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2019-04-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2019.00270/full |
| _version_ | 1818508340739702784 |
|---|---|
| author | Wen-Wen Zhang Qin Tong Jia-Yuan Sun Xin Hua Zhi-Qing Long Jia-Peng Deng Yong Dong Feng-Yan Li Zhen-Yu He San-Gang Wu Huan-Xin Lin |
| author_facet | Wen-Wen Zhang Qin Tong Jia-Yuan Sun Xin Hua Zhi-Qing Long Jia-Peng Deng Yong Dong Feng-Yan Li Zhen-Yu He San-Gang Wu Huan-Xin Lin |
| author_sort | Wen-Wen Zhang |
| collection | DOAJ |
| description | Introduction: It is still controversial whether post-mastectomy radiotherapy (PMRT) is necessary for women with T1-2 N1mic ER-positive HER2-negative breast cancer. The 21-gene recurrence score (RS) assay has been validated in T1-2 N1 breast cancer to be prognostic of locoregional recurrence (LRR) and overall survival (OS). This study aims to evaluate the predict value of 21-gene recurrence score assay for the benefit of PMRT in T1-2 N1mic ER-positive HER2-negative breast cancer.Methods: A population-based cohort study was performed on women with T1-2 N1mic ER-positive HER2-negative breast cancer who underwent mastectomy and were evaluated using the 21-gene RS in the Surveillance, Epidemiology, and End Results (SEER) registry between 2004 and 2015. Clinical characteristics as well as OS and breast cancer-specific survival (BCSS) were compared between patients with and without PMRT in patients with a Low-, Intermediate-, and High-RS. Multivariate COX regression analysis was performed to investigate if the 21-gene RS assay could predict benefit of PMRT in this group of breast cancer patients.Results: A total of 1571 patients met the criteria of our study and were enrolled, including 970 patients in the Low-Risk group (score <18), 508 in the Intermediate-Risk group (score 18–30), and 93 patients in the High-Risk group (score >30). In the High-Risk group, there were more patients with age ≥50 (87.0 vs. 64.3%, P = 0.040) and received chemotherapy with a borderline significance (91.3 vs. 72.9%, P = 0.066) in the PMRT subgroup than in the no PMRT subgroup. In all three groups, OS was comparable between the PMRT subgroup and the no PMRT subgroup. Furthermore, multivariate analysis did not show any OS benefit for PMRT based on the 21-gene recurrence score.Conclusion: This study showed that the 21-gene RS assay was not able to predict the benefit of PMRT for OS in women with T1-2 N1mic ER-positive HER2-negative breast cancer. However, further prospective larger sample-size trials are warranted to determine if a benefit exists. |
| first_indexed | 2024-12-10T22:30:22Z |
| format | Article |
| id | doaj.art-a8dcd38da005497d85bfc95a4256bb5a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-10T22:30:22Z |
| publishDate | 2019-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-a8dcd38da005497d85bfc95a4256bb5a2022-12-22T01:31:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2019-04-01910.3389/fonc.2019.0027044340521-Gene Recurrence Score Assay Could Not Predict Benefit of Post-mastectomy Radiotherapy in T1-2 N1mic ER-Positive HER2-Negative Breast CancerWen-Wen Zhang0Qin Tong1Jia-Yuan Sun2Xin Hua3Zhi-Qing Long4Jia-Peng Deng5Yong Dong6Feng-Yan Li7Zhen-Yu He8San-Gang Wu9Huan-Xin Lin10State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, The First Affiliated Hospital of University of South China, Hengyang, ChinaState Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Oncology, Dongguan Third People's Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Guangdong, ChinaState Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, ChinaState Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, ChinaIntroduction: It is still controversial whether post-mastectomy radiotherapy (PMRT) is necessary for women with T1-2 N1mic ER-positive HER2-negative breast cancer. The 21-gene recurrence score (RS) assay has been validated in T1-2 N1 breast cancer to be prognostic of locoregional recurrence (LRR) and overall survival (OS). This study aims to evaluate the predict value of 21-gene recurrence score assay for the benefit of PMRT in T1-2 N1mic ER-positive HER2-negative breast cancer.Methods: A population-based cohort study was performed on women with T1-2 N1mic ER-positive HER2-negative breast cancer who underwent mastectomy and were evaluated using the 21-gene RS in the Surveillance, Epidemiology, and End Results (SEER) registry between 2004 and 2015. Clinical characteristics as well as OS and breast cancer-specific survival (BCSS) were compared between patients with and without PMRT in patients with a Low-, Intermediate-, and High-RS. Multivariate COX regression analysis was performed to investigate if the 21-gene RS assay could predict benefit of PMRT in this group of breast cancer patients.Results: A total of 1571 patients met the criteria of our study and were enrolled, including 970 patients in the Low-Risk group (score <18), 508 in the Intermediate-Risk group (score 18–30), and 93 patients in the High-Risk group (score >30). In the High-Risk group, there were more patients with age ≥50 (87.0 vs. 64.3%, P = 0.040) and received chemotherapy with a borderline significance (91.3 vs. 72.9%, P = 0.066) in the PMRT subgroup than in the no PMRT subgroup. In all three groups, OS was comparable between the PMRT subgroup and the no PMRT subgroup. Furthermore, multivariate analysis did not show any OS benefit for PMRT based on the 21-gene recurrence score.Conclusion: This study showed that the 21-gene RS assay was not able to predict the benefit of PMRT for OS in women with T1-2 N1mic ER-positive HER2-negative breast cancer. However, further prospective larger sample-size trials are warranted to determine if a benefit exists.https://www.frontiersin.org/article/10.3389/fonc.2019.00270/fullbreast cancermicrometastasis of lymph nodespost-mastectomy radiotherapy (PMRT)21-gene recurrence score (RS) assaysurveillanceepidemiology |
| spellingShingle | Wen-Wen Zhang Qin Tong Jia-Yuan Sun Xin Hua Zhi-Qing Long Jia-Peng Deng Yong Dong Feng-Yan Li Zhen-Yu He San-Gang Wu Huan-Xin Lin 21-Gene Recurrence Score Assay Could Not Predict Benefit of Post-mastectomy Radiotherapy in T1-2 N1mic ER-Positive HER2-Negative Breast Cancer Frontiers in Oncology breast cancer micrometastasis of lymph nodes post-mastectomy radiotherapy (PMRT) 21-gene recurrence score (RS) assay surveillance epidemiology |
| title | 21-Gene Recurrence Score Assay Could Not Predict Benefit of Post-mastectomy Radiotherapy in T1-2 N1mic ER-Positive HER2-Negative Breast Cancer |
| title_full | 21-Gene Recurrence Score Assay Could Not Predict Benefit of Post-mastectomy Radiotherapy in T1-2 N1mic ER-Positive HER2-Negative Breast Cancer |
| title_fullStr | 21-Gene Recurrence Score Assay Could Not Predict Benefit of Post-mastectomy Radiotherapy in T1-2 N1mic ER-Positive HER2-Negative Breast Cancer |
| title_full_unstemmed | 21-Gene Recurrence Score Assay Could Not Predict Benefit of Post-mastectomy Radiotherapy in T1-2 N1mic ER-Positive HER2-Negative Breast Cancer |
| title_short | 21-Gene Recurrence Score Assay Could Not Predict Benefit of Post-mastectomy Radiotherapy in T1-2 N1mic ER-Positive HER2-Negative Breast Cancer |
| title_sort | 21 gene recurrence score assay could not predict benefit of post mastectomy radiotherapy in t1 2 n1mic er positive her2 negative breast cancer |
| topic | breast cancer micrometastasis of lymph nodes post-mastectomy radiotherapy (PMRT) 21-gene recurrence score (RS) assay surveillance epidemiology |
| url | https://www.frontiersin.org/article/10.3389/fonc.2019.00270/full |
| work_keys_str_mv | AT wenwenzhang 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT qintong 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT jiayuansun 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT xinhua 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT zhiqinglong 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT jiapengdeng 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT yongdong 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT fengyanli 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT zhenyuhe 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT sangangwu 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer AT huanxinlin 21generecurrencescoreassaycouldnotpredictbenefitofpostmastectomyradiotherapyint12n1micerpositiveher2negativebreastcancer |