title: [Impact of the 21-gene assay in decision-making during multidisciplinary breast meeting: A French experience].
abstract: OBJECTIVE
  The 21-gene assay (Oncotype DX(®)) test is used to estimate the risk of recurrence and to predict the benefit of adjuvant chemotherapy at an early stage of endocrine responsive breast cancers, without HER2 overexpression or amplification. This test corresponds to a recurrence score (RS), classifying patients into three groups (low, intermediate or high risk). The objective of this two-center prospective study is to define the impact of Oncotype DX(®) in clinical practice.
  
  
  METHODS
  Between August 2013 and May 2015, an Oncotype DX(®) test was decided in multidisciplinary meeting, to certain patients with an indication of adjuvant chemotherapy for HR+ and HER2 negative cancers. The therapeutic changes after knowledge of RS were collected. An estimate of the economic impact was performed and a correlation between the RS and usual breast cancer prognostic markers was investigated.
  
  
  RESULTS
  Thirty-nine patients had a test, twenty-six (66.7%) of them have finally been no indication retaining chemotherapy. The economy obtained through the use of the test was estimated around 173,000euros. It has not been demonstrated correlation between the RS, the usual decisional and prognostic factors for breast cancer or with adjuvant! Online.
  
  
  CONCLUSIONS
  The RS has an additional decision value compared to other common decision criteria. Use of Oncotype DX(®) reduced in our experience the indications of adjuvant chemotherapy. The medical and economic impact could be significant.
authors.affiliation: Service de gynécologie-obstétrique, université Paris XIII-Bobigny, AP-HP, Jean-Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Dreyfus
authors.affiliation: Service de gynécologie-obstétrique, Sorbonne université, AP-HP, Tenon, IUC-UPMC, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Ballester
authors.affiliation: Service d'oncologie médicale, Sorbonne université, AP-HP, Tenon, IUC-UPMC, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Gligorov
authors.affiliation: Service d'oncologie médicale, université Paris XIII-Bobigny, AP-HP, Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France.
authors.forename: P
authors.initials: P
authors.lastname: Agranat
authors.affiliation: Laboratoire d'anatomopathologie, Sorbonne université, AP-HP, Tenon, IUC-UPMC, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Antoine
authors.affiliation: Laboratoire d'anatomopathologie, université Paris XIII-Bobigny, AP-HP, Jean-Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France.
authors.forename: I
authors.initials: I
authors.lastname: Tengher
authors.affiliation: Service de gynécologie-obstétrique, université Paris XIII-Bobigny, AP-HP, Jean-Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France. Electronic address: alexandre.bricou@aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Bricou
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000737:chemistry / Q000145:classification / Q000235:genetics*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005602:France; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics*; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D012307:Risk Factors
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: 21-gene assay; Cancer du sein précoce; Chemotherapy; Chimiothérapie; Early breast cancer; Recurrence score; Signature génomique (21 gènes)