Recurrence Score Testing Does not Appear to Benefit Patients With Grade 1, Progesterone Receptor-Positive Breast Cancers: An Opportunity to Eliminate Overtreatment and Decrease Testing Costs
| Autor: | Charles Mylander, Udai S. Sibia, Carol Tweed, Thomas Sanders, Rubie Sue Jackson, Martin Rosman, Lorraine Tafra |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty Adjuvant chemotherapy medicine.medical_treatment education Recurrence score Breast Neoplasms Anne Arundel Medical Center 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine Epidemiology medicine Biomarkers Tumor Humans Lymphoma Follicular Chemotherapy medicine.diagnostic_test Overtreatment business.industry Hematology General Medicine Middle Aged medicine.disease Prognosis Progesterone Receptor Positive Receptors Estrogen 030220 oncology & carcinogenesis Female Neoplasm Recurrence Local Oncotype DX business Receptors Progesterone 030215 immunology |
| Zdroj: | Hematology/oncology and stem cell therapy. 15(1) |
| ISSN: | 2589-0646 |
| Popis: | Background We previously described a risk prediction model (Anne Arundel Medical Center [AAMC] model) based on pathology which may eliminate the need for recurrence score (RS) testing in select early-stage breast cancers. There is a concern that patients in discordant risk prediction groups (AAMC vs. RS) may be overtreated or undertreated if RS testing were omitted. Methods We queried the Surveillance, Epidemiology, and End Results (SEER) database for all breast cancer patients between 2004 and 2015. AAMC low-risk was defined as Grade 1 and progesterone receptor-positive (PR + ) tumors, while AAMC high-risk was defined as Grade 3 or estrogen-negative tumors. RS low-risk group was defined as RS 50 years. RS high-risk group was defined as RS > 25. Results A total of 71,212 cases were analyzed. Of these, 590 were AAMC low-risk/RS high-risk discordant, while 5,596 were AAMC high-risk/RS low-risk discordant. For AAMC low-risk/RS high-risk discordant, 10-year breast cancer-specific survival (BCSS) did not differ for patients who received adjuvant chemotherapy versus those who did not (93% chemotherapy vs. 99% unknown/no chemotherapy, p = .12). Overall survival (OS) was also comparable (92% chemotherapy vs. 91% unknown/no chemotherapy, p = .42). In the AAMC high-risk/RS low-risk discordant group, 10-year BCSS (92% chemotherapy vs. 96% unknown/no chemotherapy, p = .06) and OS (87% chemotherapy vs. 90% unknown/no chemotherapy, p = .52) did not differ between adjuvant chemotherapy and unknown/no chemotherapy groups. Conclusions Adjuvant chemotherapy in the AAMC low-risk/RS high-risk and AAMC high-risk/RS low-risk discordant groups did not improve survival. This supports consideration of omission of RS testing in Grade 1, PR + tumors. Patients with Grade 3 tumors do benefit from RS testing. |
| Databáze: | OpenAIRE |
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