title: The genomic expression test EndoPredict is a prognostic tool for identifying risk of local recurrence in postmenopausal endocrine receptor-positive, her2neu-negative breast cancer patients randomised within the prospective ABCSG 8 trial.
abstract: BACKGROUND
  The aim of this study was to examine whether EndoPredict (EP), a novel genomic expression test, is effective in predicting local recurrence (LR)-free survival (LRFS) following surgery for breast cancer in postmenopausal women. In addition, we examined whether EP may help tailor local therapy in these patients.
  
  
  METHODS
  From January 1996 to June 2004, 3714 postmenopausal patients were randomly assigned to either tamoxifen or tamoxifen followed by anastrozole within the prospective ABCSG 8 trial. Using assay scores from EP, we classified breast tumour blocks as either low or high risk for recurrence.
  
  
  RESULTS
  Data were gathered from 1324 patients. The median follow-up was 72.3 months and the cumulative incidence of LR was 2.6% (0.4% per year). The risk of LR over a 10-year period among patients with high-risk lesions (n=683) was significantly higher (LRFS=91%) when compared with patients with low-risk lesions (n=641) (10-year LRFS=97.5%) (HR: 1.31 (1.16-1.48) P<0.005). The groups that received breast conservation surgery (BCT) and mastectomy (MX) had similar LR rates (P=0.879). Radiotherapy (RT) after BCT significantly improved LRFS in the cohorts predicted by EP to be low-risk for LR (received RT: n=436, 10-year LRFS 99.8%; did not receive RT: n=63, 10-year LRFS 83.6%, P<0.005).
  
  
  CONCLUSIONS
  EndoPredict is an effective prognostic tool for predicting LRFS. Among postmenopausal, low-risk patients, EP does not appear to be useful for tailoring local therapy.
authors: 1] Hospital of the Sisters of Charity, Breast Health Center, Linz, Austria [2] Department of Surgery and Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria.
authors: F
authors: F
authors: Fitzal
authors: Department of Oncology, Medical University Vienna, Vienna, Austria.
authors: M
authors: M
authors: Filipits
authors: Department of Pathology, Medical University Vienna, Vienna, Austria.
authors: M
authors: M
authors: Rudas
authors: Department of Oncology, Salzburger Landesklinik, Salzburg, Austria.
authors: R
authors: R
authors: Greil
authors: Department of Pathology, Salzburger Landesklinik, Salzburg, Austria.
authors: O
authors: O
authors: Dietze
authors: Department of Oncology, Medical University Graz, Graz, Austria.
authors: H
authors: H
authors: Samonigg
authors: Department of Pathology, Medical University Graz, Graz, Austria.
authors: S
authors: S
authors: Lax
authors: Department of Surgery, KH Leoben, Leoben, Austria.
authors: W
authors: W
authors: Herz
authors: Department of Surgery and Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria.
authors: P
authors: P
authors: Dubsky
authors: Department of Oncology, Medical University Vienna, Vienna, Austria.
authors: R
authors: R
authors: Bartsch
authors: Sividon Diagnostics, Cologne, Germany.
authors: R
authors: R
authors: Kronenwett
authors: Department of Surgery and Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria.
authors: M
authors: M
authors: Gnant
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics* / Q000473:pathology; D017698:Postmenopause; D011446:Prospective Studies; D012334:RNA, Neoplasm / Q000032:analysis*; D011933:Reagent Kits, Diagnostic; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics*; D011960:Receptors, Estrogen / Q000235:genetics*; D012307:Risk Factors
chemical_list: D012334:RNA, Neoplasm; D011933:Reagent Kits, Diagnostic; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; C508053:ERBB2 protein, human