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Abstract：
This study aimed to evaluate the impacts of 21-gene recurrence score (RS) and St. Gallen International Expert Consensus on treatment decision and prognosis of patients with invasive breast cancer. We retrospectively analyzed the therapy protocol and outcome of 134 cases based on age, body mass index (BMI), menopause, pathological types, tumor-node-metastasis (TNM) stages, percentage of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), Ki-67, molecular subtype, and tumor biomarkers. RS was calculated based on 21-gene assay following traditional (old RS cutoff) and updated (new RS cutoff) National Comprehensive Cancer Network (NCCN) guideline. In addition, we also compared treatment protocol of NCCN guidelines with St. Gallen International Expert Consensus. The results showed that BMI, PR, Ki-67, and molecular subtype are critical for the evaluation of risk factors. Based on the new cutoff, low, middle, and high RS were 18%, 66%, and 16%, respectively. In contrast, based on the old cutoff, low, middle, and high RS were 60%, 29%, and 11%, respectively. The agreement rate of NCCN guidelines and St. Gallen International Expert Consensus for adjuvant treatment was 50. However, there is minimal agreement (0.151, 0.071) in kappa coefficient of old and new cutoff. This study revealed that the combination of NCCN guidelines and St. Gallen International Expert Consensus might improve the benefits of adjuvant treatment in patients with early invasive breast cancer.
摘要：
本研究旨在评估21基因复发评分（RS）和圣加伦国际专家共识对浸润性乳腺癌患者治疗决策和预后的影响。我们回顾性分析134例患者的治疗方案和结果，根据年龄，体重指数（BMI），更年期,病理类型，肿瘤淋巴结转移（TNM）分期，雌激素受体（ER）的百分比，孕激素受体（PR），人表皮生长因子2（HER2），Ki-67,分子亚型,和肿瘤生物标志物。根据传统的（旧的RS截止）和更新的（新的RS截止）国家综合癌症网络（NCCN）指南，基于21基因测定计算RS。此外,我们还将NCCN指南的治疗方案与圣加仑国际专家共识进行了比较。结果显示BMI,PR,Ki-67和分子亚型对于评估危险因素至关重要。根据新的界限，低,中间,高RS为18%，66%,16%,分别。相比之下,基于旧的界限，低,中间,高RS为60%，29%,11%,分别。NCCN指南和圣加仑国际专家共识对辅助治疗的同意率为50。然而,新旧截止值的kappa系数最小一致(0.151，0.071)。这项研究表明，NCCN指南和圣加仑国际专家共识的结合可能会提高早期浸润性乳腺癌患者辅助治疗的益处。
