title: The 21-gene recurrence score complements IBTR! Estimates in early-stage, hormone receptor-positive, HER2-normal, lymph node-negative breast cancer.
abstract: Clinicians have traditionally used clinicopathological (CP) factors to determine locoregional recurrence (LR) risk of breast cancer and have generated the IBTR! nomogram to predict the risk of ipsilateral breast tumor recurrence (IBTR). The 21-gene recurrence score (RS) assay was recently correlated with LR in retrospective studies. The objective of this study was to examine the relationship between the RS and IBTR!. CP characteristics of 308 consecutive patients who underwent RS testing at our institution were examined. IBTR! was used to estimate the risk of 10-year IBTR. Descriptive statistics were used to compare the RS with the estimated IBTR!. Given a low event rate in this cohort, actual IBTR rates were not reported. Most patients had stage I/II (98%) and grade I/II (77%) disease. Median age was 54 years (range, 30-78). Median IBTR! without radiation therapy was 10% (mean, 12% [range, 4-43%]). RS was low (<18), intermediate (18-30), and high (>30) in 52% (n = 160), 40% (n = 123), and 8% (n = 25) patients. Overall, IBTR! did not correlate with RS (P = .77). We saw no correlation between RS and IBTR! in patients with less than (P = .32) or greater than (P = .48) a 10% risk of IBTR. Interestingly, Ki-67 expression correlated with both IBTR! (P = .019) and the RS (P = .002). Further study is warranted to determine if the RS can provide complementary biological information to CP factors in estimating the risk of LR. Prospective studies evaluating this association may potentially allow for individualized treatment decisions.
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: Nikhil G
authors: NG
authors: Thaker
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: Karen E
authors: KE
authors: Hoffman
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: Michael C
authors: MC
authors: Stauder
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: Simona F
authors: SF
authors: Shaitelman
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: Eric A
authors: EA
authors: Strom
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: Welela
authors: W
authors: Tereffe
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: Benjamin D
authors: BD
authors: Smith
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: George H
authors: GH
authors: Perkins
authors: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA.
authors: Lei
authors: L
authors: Huo
authors: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX USA.
authors: Mark F
authors: MF
authors: Munsell
authors: Department of Medical Oncology, Yale Cancer Center, New Haven, CT USA.
authors: Lajos
authors: L
authors: Pusztai
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: Thomas A
authors: TA
authors: Buchholz
authors: Department of Radiation Oncology, Unit 1202, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030 USA.
authors: Wendy A
authors: WA
authors: Woodward
keywords: 21-gene recurrence score; IBTR!; Ipsilateral breast tumor recurrence; Local recurrence; Molecular profiling; Oncotype Dx