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Breast Cancer Research and Treatment
Erschienen in:

27.01.2022 | Preclinical study

Utility of Oncotype DX score in clinical management for T1 estrogen receptor positive, HER2 negative, and lymph node negative breast cancer

verfasst von: Thi Truc Anh Nguyen, Lauren M. Postlewait, Chao Zhang, Jane L. Meisel, Ruth O’Regan, Sunil Badve, Kevin Kalinsky, Xiaoxian Li

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 3/2022

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Abstract

Background

The management of estrogen receptor positive (ER+)/HER2− and lymph node (LN) negative breast cancers can be influenced by Oncotype DX recurrence score (RS) in the USA. However, the benefit of RS in T1 tumors (≤ 1 cm) is not clear.

Methods

We retrieved 199 T1 ER+/HER2−/LN− breast cancer diagnosed between 1993 and 2016 that had undergone RS testing. The median follow-up time was 51 months. We examined the disease-free survival (DFS) and distant metastasis and their association with RS and other clinicopathologic features.

Results

Of the 199 cases, 40 were T1a (≤ 0.5 cm) and 159 were T1b (> 0.5 cm to 1 cm) tumors. In the 40 T1a tumors, 11 would benefit from chemotherapy by the TAILORx study results. Of these T1a tumors, 36 were Nottingham grade 1/2, 3 were grade 3, and 1 was microinvasive carcinoma; 2 (5%) had local recurrence and 1 (2.5%) had distant metastasis to the bone. The only patient with T1a tumor (Nottingham grade 3, RS = 42) and distant metastasis to bone had received adjuvant chemotherapy. In the 159 T1b tumors, 25 would benefit chemotherapy by the TAILORx results. Of the T1b tumors, 149 were Nottingham grade 1/2 and 10 were grade 3. Nine (5.7%) had local recurrence and 2 (1.3%) had distant metastasis to bone and mediastinum, respectively. The two T1b tumors with distant metastasis had a RS 20 and Nottingham grade 2, and RS 27 and Nottingham grade 3, respectively. Both patients received adjuvant chemotherapy. In multivariate analysis of the entire cohort (T1a and T1b tumors), Nottingham tumor grade and receiving chemotherapy were significantly associated with DFS. In univariate analysis of the entire cohort, Nottingham tumor grade, receiving adjuvant chemotherapy, and RS were significantly associated with distant metastasis.

Conclusion

This study demonstrates that the metastatic rate of T1a and T1b ER+/HER2−/LN− breast cancer is very low. Patients with low grade (1 or 2), T1a ER+/HER2−/LN− breast cancer may not need RS for treatment decision-making; however, in patients with high-grade T1a or T1b ER+/HER2−/LN− breast cancer, RS analysis should be strongly considered.
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Metadaten
Titel
Utility of Oncotype DX score in clinical management for T1 estrogen receptor positive, HER2 negative, and lymph node negative breast cancer
verfasst von
Thi Truc Anh Nguyen
Lauren M. Postlewait
Chao Zhang
Jane L. Meisel
Ruth O’Regan
Sunil Badve
Kevin Kalinsky
Xiaoxian Li
Publikationsdatum
27.01.2022
Verlag
Springer US
Erschienen in
Breast Cancer Research and Treatment / Ausgabe 3/2022
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-022-06530-6

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