Journal Article
. 2018 Sep;172(3).
doi: 10.1007/s10549-018-4955-z.

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

Jing Li Huang 1 Scott Kizy 1 Schelomo Marmor 1 Ariella Altman 1 Anne Blaes 2 Heather Beckwith 2 Todd M Tuttle 1 Jane Yuet Ching Hui 3 
Affiliations
  • PMID: 30196425
  •     5 citations

Abstract

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 < 5% probability of having high-risk RS regardless of other patient demographic or pathologic factors. This suggests that the histologic factors of grade and PR status should be taken into consideration before ordering the 21-gene recurrence score assay.

Keywords: 21-Gene recurrence score; Breast cancer; Grade; Oncotype DX; Progesterone receptor.

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