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 
  • PMID: 30196425
  •     5 citations


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.

Dietary Modification and Breast Cancer Mortality: Long-Term Follow-Up of the Women's Health Initiative Randomized Trial.
Rowan T Chlebowski, Aaron K Aragaki, +14 authors, Women’s Health Initiative.
J Clin Oncol, 2020 Feb 08; 38(13). PMID: 32031879    Free PMC article.
Clinicopathological characteristics, adjuvant chemotherapy decision and disease outcome in patients with breast cancer with a 21-gene recurrence score of 26-30.
Jing Yu, Jiayi Wu, +6 authors, Kunwei Shen.
Oncol Lett, 2020 Jul 30; 20(2). PMID: 32724396    Free PMC article.
Concordance of the 21-gene assay between core needle biopsy and resection specimens in early breast cancer patients.
Peng Qi, Yu Yang, +5 authors, Xiao-Yan Zhou.
Breast Cancer Res Treat, 2021 Jan 14;. PMID: 33439420    Free PMC article.
Concordance between results of inexpensive statistical models and multigene signatures in patients with ER+/HER2- early breast cancer.
Laurence Slembrouck, Isabelle Vanden Bempt, +12 authors, Giuseppe Floris.
Mod Pathol, 2021 Feb 10;. PMID: 33558657
A nomogram to predict the high-risk RS in HR+/HER2-breast cancer patients older than 50 years of age.
Jing Yu, Jiayi Wu, +6 authors, Kunwei Shen.
J Transl Med, 2021 Feb 18; 19(1). PMID: 33593381    Free PMC article.