Tumor grade and progesterone receptor status predict 21-gene recurrence score in early stage invasive breast carcinoma

Purpose The 21-gene recurrence score (RS) assay is increasingly utilized to predict the risk of recurrence in early stage estrogen receptor (ER)-positive breast cancer. We hypothesize that tumor grade and progesterone receptor (PR) status predict RS categorization. Methods We identified women betwee...

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Bibliographic Details
Published in:Breast cancer research and treatment 2018-12, Vol.172 (3), p.671-677
Main Authors: Huang, Jing Li, Kizy, Scott, Marmor, Schelomo, Altman, Ariella, Blaes, Anne, Beckwith, Heather, Tuttle, Todd M., Hui, Jane Yuet Ching
Format: Article
Language:English
Subjects:
Adult
Aged
Breast cancer
Breast carcinoma
Breast Neoplasms - chemistry
Breast Neoplasms - pathology
Cancer research
Epidemiology
Estrogen receptors
Female
Humans
Invasiveness
Logistic Models
Lymph nodes
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Grading
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - etiology
Neoplasm Staging
Oncology
Progesterone
Receptors, Progesterone - analysis
Risk groups
Tumors
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Summary:Purpose The 21-gene recurrence score (RS) assay is increasingly utilized to predict the risk of recurrence in early stage estrogen receptor (ER)-positive breast cancer. We hypothesize that tumor grade and progesterone receptor (PR) status predict RS categorization. Methods We identified women between the ages of 18 and 74 years with stage I or II, ER-positive, invasive carcinoma of the breast from the Surveillance Epidemiology End-Results database from 2010 to 2013. Multivariable logistic regression was performed to determine factors associated with high-risk RS. Results We identified 42,530 patients that met inclusion criteria. Multivariable logistic regression demonstrated that grade I tumors [OR (odds ratio) 0.33, 95% CI (confidence interval) 0.31–0.37] and PR positive (PR+) status (OR 0.16, 95% CI 0.15–0.17) were significantly less likely to be associated with high-risk RS. Of patients with grade I PR+ tumors, 1% was in the high-risk group by the traditional cutoffs and 4% was in the high-risk group by the TAILORx cutoffs. The percentage of patients with high-risk RS remained low for grade I PR+ tumors regardless of age, race, tumor size, and lymph node status. Conclusions We found that grade I PR+ tumors are associated a 
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-018-4955-z