21-gene recurrence score and adjuvant chemotherapy decisions in patients with invasive lobular breast cancer

Biomark Med. 2019 Feb;13(2):83-93. doi: 10.2217/bmm-2018-0396. Epub 2018 Dec 19.

Abstract

Aim: To determine the effect of the 21-gene recurrence score (RS) on outcome and chemotherapy decision in breast invasive lobular carcinoma (ILC).

Materials & methods: We included 6467 patients with early stage and estrogen receptor-positive ILC from the Surveillance, epidemiology, and end results database.

Results: A total of 9.1, 31.4, and 70.1% of patients with low-, intermediate-, and high-risk RS groups received chemotherapy, respectively. A higher RS was independently associated with poor breast cancer-specific survival, and receipt of chemotherapy was not related to better breast cancer-specific survival in low-, intermediate-, or high-risk RS groups.

Conclusion: The 21-gene RS could impact chemotherapy decision making in early-stage ILC. However, adjuvant chemotherapy does not appear to improve outcome in high-risk RS cohort.

Keywords: Oncotype DX; breast carcinoma; chemotherapy; decision; invasive lobular carcinoma; prognostic analysis; recurrence score; risk factor; survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / genetics*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / genetics
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology
  • Carcinoma, Lobular / drug therapy
  • Carcinoma, Lobular / genetics
  • Carcinoma, Lobular / mortality*
  • Carcinoma, Lobular / pathology
  • Chemotherapy, Adjuvant / mortality*
  • Cohort Studies
  • Decision Making*
  • Female
  • Follow-Up Studies
  • Gene Expression Profiling
  • Humans
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / genetics
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Prognosis
  • Survival Rate
  • Young Adult

Substances

  • Biomarkers, Tumor