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31.12.2023 | Breast Oncology

Defining the Biology of Estrogen Receptor-Low-Positive Breast Cancer

verfasst von: Tessa Higgins, BA, Olga Kantor, MD, Beth Harrison, MD, Julia Giordano, BA, Monica McGrath, BS, Harold J. Burstein, MD, PhD, Stuart J. Schnitt, MD, Tasnim Rahman, MBA, Halley Vora, MD, Ana Garrido-Castro, MD, Sara M. Tolaney, MD, MPH, Funda Meric-Bernstam, MD, Tari A. King, MD, Elizabeth A. Mittendorf, MD, PhD, MHCM

Erschienen in: Annals of Surgical Oncology | Ausgabe 4/2024

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Abstract

Background

We sought to better define estrogen receptor-low-positive (ER-low+) breast cancer biology and determine the utility of the Oncotype DX Breast Recurrence Score® (RS) assay in this population.

Methods

Patients with information regarding percentage ER positivity and PAM50 subtype were identified in The Cancer Genome Atlas (TCGA) and subtype distribution was determined. Next, patients with ER-low+ (ER 1–10%), HER2− breast cancer undergoing upfront surgery with known RS result were identified in the National Cancer Database (NCDB) and our institutional Dana-Farber Brigham Cancer Center (DF/BCC) database; RS distribution was examined. Finally, patients with ER-low+, HER2− breast cancer treated at DF/BCC from 2011 to 2020 without prior RS results and in whom tissue was available to perform the assay were identified. RS results, treatment, recurrence and breast cancer-specific survival (BCSS) were determined.

Results

Of 1033 patients in TCGA, ER percentage and PAM50 subtype were available for 342 (33.1%) patients. Forty-six (13.5%) had ER-low+/HER2− tumors, among whom 82.6% were basal and 4.3% were luminal A. Among 3423 patients with ER-low+/HER2− disease in the NCDB, RS results were available for 689 (20.1%) patients; 67% had an RS ≥26. In our institutional database, only two patients with ER-low+/HER2− disease and an RS were identified, both with RS ≥26. Among 37 patients in our institutional cohort without prior RS, 35 (97.4%) had an RS ≥26, determined with testing. After a median follow-up of 40 months (range 3–106), three patients, all treated with chemotherapy, recurred. Three-year BCSS was 97.0% (95% confidence interval 96.9–97.1%).

Conclusions

Most ER-low+/HER2− breast cancers are basal-like, with RS ≥26 suggesting these tumors are similar to triple-negative disease.
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Metadaten
Titel
Defining the Biology of Estrogen Receptor-Low-Positive Breast Cancer
verfasst von
Tessa Higgins, BA
Olga Kantor, MD
Beth Harrison, MD
Julia Giordano, BA
Monica McGrath, BS
Harold J. Burstein, MD, PhD
Stuart J. Schnitt, MD
Tasnim Rahman, MBA
Halley Vora, MD
Ana Garrido-Castro, MD
Sara M. Tolaney, MD, MPH
Funda Meric-Bernstam, MD
Tari A. King, MD
Elizabeth A. Mittendorf, MD, PhD, MHCM
Publikationsdatum
31.12.2023
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 4/2024
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-14835-z

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