title: A new molecular prognostic score for predicting the risk of distant metastasis in patients with HR+/HER2- early breast cancer.
abstract: To make an optimal treatment decision for early stage breast cancer, it is important to identify risk of recurrence. Here, we developed and validated a new prognostic model for predicting the risk of distant metastasis in patients with pN0-N1, hormone receptor-positive, HER2-negative (HR+/HER2-) breast cancer treated with hormone therapy alone. RNA was extracted from formalin-fixed, paraffin-embedded tumor tissues and gene expression was measured by quantitative real-time reverse transcription-PCR. The relative expression of six novel prognostic genes was combined with two clinical variables (nodal status and tumor size) to calculate a risk score (BCT score). In the validation cohort treated with hormone therapy alone, the 10 year rate of distant metastasis in the high-risk group (26.3%) according to BCT score was significantly higher than that in the low-risk group (3.8%) (P < 0.001). Multivariate analysis adjusted for clinical variables revealed that BCT score is an independent predictor of distant metastasis. Moreover, the C-index estimate revealed that BCT score has a prognostic power superior to that of prognostic models based on clinicopathological parameters. The BCT score outperforms prognostic models based on traditional clinicopathological factors and predicts the risk of distant metastasis in patients with HR+/HER2- early breast cancer.
authors.affiliation: Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, Korea.
authors.forename: Gyungyub
authors.initials: G
authors.lastname: Gong
authors.affiliation: College of Pharmacy, Kyungpook National University, Daegu, 41566, Korea.|Research Institute of Pharmaceutical Sciences, College of Pharmacy, Kyungpook National University, Daegu, 41566, Korea.
authors.forename: Mi Jeong
authors.initials: MJ
authors.lastname: Kwon
authors.affiliation: Gencurix, Inc., Seoul, 08394, Korea.
authors.forename: Jinil
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06356, Korea.
authors.forename: Se Kyung
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06356, Korea.
authors.forename: Jeong Eon
authors.initials: JE
authors.lastname: Lee
authors.affiliation: Department of Nursing Science, College of Nursing, Gachon University, Incheon, 21936, Korea.
authors.forename: Seon-Heui
authors.initials: SH
authors.lastname: Lee
authors.affiliation: The Center for Anti-cancer Companion Diagnostics, Bio-MAX/N-Bio, Seoul National University, Seoul, 08826, Korea.
authors.forename: Sarah
authors.initials: S
authors.lastname: Park
authors.affiliation: The Center for Anti-cancer Companion Diagnostics, Bio-MAX/N-Bio, Seoul National University, Seoul, 08826, Korea.
authors.forename: Jong-Sun
authors.initials: JS
authors.lastname: Choi
authors.affiliation: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06356, Korea.
authors.forename: Soo Youn
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, Korea.
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Ahn
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505, Korea.
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Gencurix, Inc., Seoul, 08394, Korea.
authors.forename: Sang Rae
authors.initials: SR
authors.lastname: Cho
authors.affiliation: Gencurix, Inc., Seoul, 08394, Korea.
authors.forename: Youngho
authors.initials: Y
authors.lastname: Moon
authors.affiliation: Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, 10408, Korea.
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Nam
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06356, Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Nam
authors.affiliation: Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06356, Korea.|Laboratory of Cancer Genomics and Molecular Pathology, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06356, Korea.|Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, 06356, Korea.
authors.forename: Yoon-La
authors.initials: YL
authors.lastname: Choi
authors.affiliation: The Center for Anti-cancer Companion Diagnostics, Bio-MAX/N-Bio, Seoul National University, Seoul, 08826, Korea.|Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, 08826, Korea.|Laboratory of Molecular Pathology and Cancer Genomics, College of Pharmacy, Seoul National University, Seoul, 08826, Korea.
authors.forename: Young Kee
authors.initials: YK
authors.lastname: Shin
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000556:secondary*; D003661:Decision Support Techniques; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging*; D057089:Pathology, Molecular / Q000379:methods*; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014157:Transcription Factors / Q000032:analysis*
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D014157:Transcription Factors; C490267:HR protein, human; C508053:ERBB2 protein, human