Predicting a local recurrence after breast-conserving therapy by gene expression profiling.
BACKGROUND
To tailor local treatment in breast cancer patients there is a need for predicting ipsilateral recurrences after breast-conserving therapy. After adequate treatment (excision with free margins and radiotherapy), young age and incompletely excised extensive intraductal component are predictors for local recurrence, but many local recurrences can still not be predicted. Here we have used gene expression profiling by microarray analysis to identify gene expression profiles that can help to predict local recurrence in individual patients.


METHODS
By using previously established gene expression profiles with proven value in predicting metastasis-free and overall survival (wound-response signature, 70-gene prognosis profile and hypoxia-induced profile) and training towards an optimal prediction of local recurrences in a training series, we establish a classifier for local recurrence after breast-conserving therapy.


RESULTS
Validation of the different gene lists shows that the wound-response signature is able to separate patients with a high (29%) or low (5%) risk of a local recurrence at 10 years (sensitivity 87.5%, specificity 75%). In multivariable analysis the classifier is an independent predictor for local recurrence.


CONCLUSIONS
Our findings indicate that gene expression profiling can identify subgroups of patients at increased risk of developing a local recurrence after breast-conserving therapy.
Nuyten
Dimitry S A
DS
Department of Radiation Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Kreike
Bas
B
Hart
Augustinus A M
AA
Chi
Jen-Tsan Ashley
JT
Sneddon
Julie B
JB
Wessels
Lodewyk F A
LF
Peterse
Hans J
HJ
Bartelink
Harry
H
Brown
Patrick O
PO
Chang
Howard Y
HY
van de Vijver
Marc J
MJ
D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000235:genetics* / Q000628:therapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000235:genetics* / Q000628:therapy; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics* / Q000473:pathology; D009367:Neoplasm Staging; D020411:Oligonucleotide Array Sequence Analysis; D011237:Predictive Value of Tests; D011878:Radiotherapy