■并非所有合格的乳腺癌(BC)患者都能负担得起21基因复发评分(RS)测定的昂贵测试。本研究旨在确定与高危RS相关的临床病理因素,并检查这些因素是否与化疗的益处相关。
■诊断为早期BC的患者,node-negative,从监测中发现雌激素受体阳性疾病,流行病学,和结束结果OncotypeDX数据库。
■我们包括74,605名患者。那些级别较高(p<0.001)和孕激素受体阴性(PRNeg)(p<0.001)的患者发生高风险RS的几率最高。其中,3.2%,10.1%,39.1%,18.6%,41.6%,80.1%有PR阳性(PRPos)/高分化(G1)的高危RS肿瘤,PR位置/中度分化(G2),PRPos/差和/或未分化(G3),PRNeg/G1、PRNeg/G2和PRNeg/G3组,分别。在高风险RS队列中,接受化疗与改善乳腺癌特异性生存率(p=0.010)和总生存率(p<0.001)相关。然而,在PRNeg/G3疾病患者和其他组中,按级别和PR状态进行分层后,化疗无生存获益(均p≥0.05).
■我们的研究有助于改进RS检测的患者选择,鉴于其经济影响,这是至关重要的。然而,21基因RS仍然是治疗决策的关键。
UNASSIGNED: Not all eligible breast cancer (BC) patients could afford the expensive test of 21-gene recurrence score (RS) assay. This study aimed to identify clinicopathological factors associated with high-risk RS and examine whether these factors correlate with the benefit of chemotherapy.
UNASSIGNED: Patients diagnosed with early-stage BC, node-negative, and estrogen receptor-positive disease were identified from the Surveillance, Epidemiology, and End Results Oncotype DX database.
UNASSIGNED: We included 74,605 patients. Those with higher grade (p < 0.001) and progesterone receptor-negative (PR Neg) (p < 0.001) had the highest odds of a high-risk RS. Among them, 3.2%, 10.1%, 39.1%, 18.6%, 41.6%, and 80.1% had high-risk RS tumors in PR-positive (PR Pos)/well-differentiated (G1), PR Pos/moderately differentiated (G2), PR Pos/poorly and/or undifferentiated (G3), PR Neg/G1, PR Neg/G2, and PR Neg/G3 groups, respectively. Receipt of chemotherapy was associated with improved breast cancer-specific survival (p = 0.010) and overall survival (p < 0.001) in high-risk RS cohort. However, there were no survival benefits from chemotherapy in patients with PR Neg/G3 disease and other groups after stratification by grade and PR status (all p ≥ 0.05).
UNASSIGNED: Our study aids in refining patient selection for the RS testing, which is crucial given its economic implications. However, 21-gene RS remains pivotal for treatment decision-making.