Abstract
Aim
The PREDICT score is used to help define decisions about benefits of chemotherapy in early invasive breast cancer. With a PREDICT score of 5% or more chemotherapy should be considered, 3% to 4% is a borderline decision and less than 3% chemotherapy is not pursued. We set out to compare the PREDICT score to Oncotype Dx recurrence score (RS), which predicts chemotherapy benefit based on 21-gene breast cancer assay.
Method
Data for patient and tumour characteristics, and treatment choice was collected from electronic patient records of 98 patients who had an RS score done between February 2017-September 2020. This data was then compared to the patients’ PREDICT scores.
Results
98 patients were analysed with 2 excluded due to having nodal macro-metastases. Mean patient age was 53 years with an average tumour size of 27mm. 31/96 (32%) patients had a PREDICT score ≥5%, with 21/31 (68%) having a low RS score (<26). 57/96 (59%) patients had a PREDICT score of 3-4%, with 40/57 (70%) having a low RS score. 8/96 (8%) patients had a PREDICT score of < 3%, with 7/8 (88%) having a low RS score. Additionally, 7/8 (88%) patients in this group were pre-menopausal.
Conclusions
68% of patients in the ≥5% PREDICT group had a low RS score and so have avoided chemotherapy. In the 3-4% group, approximately 1 in 3 tested were shown to have a chemotherapy benefit. In the <3% group most patients were pre-menopausal, and chemotherapy was safely avoided. A bigger dataset and comparison to other health boards is required.
Association Between Neutrophil-Lymphocyte Ratio and Oncotype Dx Recurrence Score in Early-Stage Hormonal Receptor-Positive, HER2-Negative, Node-Negative Breast Cancer
