recurrence score
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2021 ◽  
Author(s):  
Andrea Delli Pizzi ◽  
Domenico Mastrodicasa ◽  
Antonio Maria Chiarelli ◽  
Piero Chiacchiaretta ◽  
Riccardo Luberti ◽  
...  

Abstract Oncotype Dx is a genetic assay providing a recurrence score (RS) correlated with the risk of cancer recurrence and adjuvant treatment response in breast carcinoma. We investigated the ability of an MRI-based radiomics approach to predict the risk of tumor recurrence in breast cancer. A total of 62 patients with biopsy-proved ER+/HER2- early breast cancer who underwent pre-treatment MRI and Oncotype Dx were included. An RS>25 was considered discriminant between low-intermediate and high risk of tumor recurrence. Two readers segmented each tumor. Radiomics features were extracted from the tumor and the peritumoral tissues. Partial least square (PLS) regression was used as the multivariate machine-learning algorithm. PLS β-weights of radiomics features included the 5% features with the largest β-weights in magnitude (top 5%). The diagnostic performance of the radiomics model was assessed through receiver operating characteristic (ROC) analysis. A null hypothesis probability threshold of 5% was chosen (p < 0.05). The predictive model delivered an AUC of 0.76. Of the 47 features included in the top 5%, 33 were texture-related and derived from the tumor and the peritumoral tissues. After a prospective evaluation in more extensive clinical trials, this approach may identify non-invasively patients who are more likely to benefit from adjuvant therapy.


Oncology ◽  
2021 ◽  
Author(s):  
Kei Yamaguchi ◽  
Ryoichi Matsunuma ◽  
Ryosuke Hayami ◽  
Michiko Tsuneizumi

Introduction: Not only the 21-gene recurrence score (RS) assay but also online prognostic tools and immunohistochemical prognostic models predict chemotherapy benefits for women with early breast cancer. Multi-gene assays, including Oncotype DX, are expensive and not covered by insurance in some countries. Methods: In this study, we retrospectively analyzed a series of 155 patients with estrogen receptor-positive primary breast cancer for whom an Oncotype DX assay was performed between January 2016 and August 2021. The patients’ modified immunohistochemical marker (mIHC4) scores were calculated on the basis of their pathological reports. The correlations of the RS with the online tool PREDICT and mIHC4 scores were evaluated. Results: Of the patients, 43.9% were premenopausal, 147 (94.8%) had T1 or T2 tumor, and 55.5% had no positive lymph nodes. Low (0–10), intermediate (11–25), and high RSs (26–100) were obtained in 16.1%, 61.9%, and 21.9% of the patients, respectively. The RS showed no correlation with the PREDICT score (r = 0.2720) but correlated with the mIHC4 score (r = 0.6356). In addition, a stronger correlation was observed in the patients with no node involvement and in the postmenopausal patients (r = 0.6609 and r = 0.7277, respectively). Conclusions: A relatively strong correlation was observed between the RS and the mIHC4 score. The mIHC4 score is a potentially easy and useful tool to guide adjuvant chemotherapy decision making especially for postmenopausal patients with no node involvement if a genomic test could not be performed for some reason.


Cancer ◽  
2021 ◽  
Author(s):  
Megan E. Tesch ◽  
Caroline Speers ◽  
Rekha M. Diocee ◽  
Lovedeep Gondara ◽  
Stuart J. Peacock ◽  
...  

Breast Care ◽  
2021 ◽  
Author(s):  
Michael Braun ◽  
Antonia Kriegmair ◽  
Nina Szeterlak ◽  
Anne Andrulat ◽  
Simone Schrodi ◽  
...  

Introduction The aim of the present study was to analyze the performance of Oncotype DX® multigene assay (ODX) in patients with 0-3 lymph nodes in a high volume community hospital. Methods Patients with non-metastatic HR+/HER2- EBC and 0-3 positive lymph nodes, who underwent primary surgery at the Red Cross Hospital Munich, Germany and consecutively had ODX testing were included in this retrospective study. The distribution of clinico-pathologic characteristics, recurrence score (RS) risk and use of systemic therapy were compared among patients without positive lymph nodes (N0) and patients with micrometastases or 1 to 3 positive lymph nodes (N1). Disease free survival (DFS) and overall survival (OS) were estimated. Results From 2012 to2017 ODX was consecutively performed in 575 (16.4%) of 3492 women with HR+/ HER- EBC, of which 553 were eligible for this analysis (N0: 60.8%; N1: 39.2%). Among the patients included, 441 (79.7%) had a RS of 0 to 25 and 112 (20.3%) had a RS of 26 or higher. In patients with RS 0 to 25 the rate of chemotherapy use was low, independent from nodal status (N0: 17.1% and N1: 19.1%) and 5y-DFS was 90.5% and 91.7% for N0 and N1 patients, respectively. There was no significant difference in DFS (90.5% vs. 93.3%; p= 0.101) or OS (97.2% vs. 96.0%; p= 0.737) for patients with a RS 0 to 25 when treated with chemo-endocrine therapy or endocrine therapy alone, independent from nodal status. Conclusions The results of the study confirm the observations from randomized studies on the use of the ODX in a real world population in terms of risk distribution and patient outcome. Adjuvant chemotherapy could be safely omitted in patients with HR+/HER2- breast cancer with 0-3 positive lymph nodes and RS<25.


Author(s):  
Harriet T. Rothschild ◽  
Mary Kathryn Abel ◽  
Anne Patterson ◽  
Kent Goodman ◽  
Amy Shui ◽  
...  

Abstract 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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