The 70-gene prognosis signature predicts early metastasis in breast cancer patients between 55 and 70 years of age.
BACKGROUND
The majority of breast cancer patients are postmenopausal women who are increasingly being offered adjuvant chemotherapy. Since the beneficial effect of chemotherapy in postmenopausal patients predominantly occurs in the first 5 years after diagnosis, a prognostic marker for early events can be of use for adjuvant treatment decision making. The aim of this study was to evaluate the prognostic value of the 70-gene prognosis signature for early events in postmenopausal patients.


METHODS
Frozen tumor samples from 148 patients aged 55-70 years were selected (T1-2, N0) and classified by the 70-gene prognosis signature (MammaPrint) into good or poor prognosis. Eighteen percent received hormonal therapy.


RESULTS
Breast cancer-specific survival (BCSS) at 5 years was 99% for the good-prognosis signature versus 80% for the poor-prognosis signature group (P = 0.036). The 70-gene prognosis signature was a significant and independent predictor of BCCS during the first 5 years of follow-up with an adjusted hazard ratio of 14.4 (95% confidence interval 1.7-122.2; P = 0.01) at 5 years.


CONCLUSIONS
The 70-gene prognosis signature can accurately select postmenopausal patients at low risk of breast cancer-related death within 5 years of diagnosis and can be of clinical use in selecting postmenopausal women for adjuvant chemotherapy.
Mook
S
S
Department of Pathology.
Schmidt
M K
MK
Department of Epidemiology.
Weigelt
B
B
Department of Experimental Therapy.
Kreike
B
B
Department of Radiation Oncology, The Netherlands Cancer Institute.
Eekhout
I
I
Department of Pathology.
van de Vijver
M J
MJ
Department of Pathology.
Glas
A M
AM
Department of Agendia BV.
Floore
A
A
Department of Agendia BV.
Rutgers
E J T
EJT
Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
van 't Veer
L J
LJ
Department of Pathology; Department of Agendia BV. Electronic address: l.vt.veer@nki.nl.
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis* / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors; D046888:Tissue Array Analysis