Tumor grade and progesterone receptor status predict 21-gene recurrence score in early stage invasive breast carcinoma

Jing Li Huang, Scott Kizy, Schelomo Marmor, Ariella Altman, Anne Blaes, Heather Beckwith, Todd M. Tuttle, Jane Yuet Ching Hui

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Purpose: The 21-gene recurrence score (RS) assay is increasingly utilized to predict the risk of recurrence in early stage estrogen receptor (ER)-positive breast cancer. We hypothesize that tumor grade and progesterone receptor (PR) status predict RS categorization. Methods: We identified women between the ages of 18 and 74 years with stage I or II, ER-positive, invasive carcinoma of the breast from the Surveillance Epidemiology End-Results database from 2010 to 2013. Multivariable logistic regression was performed to determine factors associated with high-risk RS. Results: We identified 42,530 patients that met inclusion criteria. Multivariable logistic regression demonstrated that grade I tumors [OR (odds ratio) 0.33, 95% CI (confidence interval) 0.31–0.37] and PR positive (PR+) status (OR 0.16, 95% CI 0.15–0.17) were significantly less likely to be associated with high-risk RS. Of patients with grade I PR+ tumors, 1% was in the high-risk group by the traditional cutoffs and 4% was in the high-risk group by the TAILORx cutoffs. The percentage of patients with high-risk RS remained low for grade I PR+ tumors regardless of age, race, tumor size, and lymph node status. Conclusions: We found that grade I PR+ tumors are associated a < 5% probability of having high-risk RS regardless of other patient demographic or pathologic factors. This suggests that the histologic factors of grade and PR status should be taken into consideration before ordering the 21-gene recurrence score assay.

Original languageEnglish (US)
Pages (from-to)671-677
Number of pages7
JournalBreast Cancer Research and Treatment
Volume172
Issue number3
DOIs
StatePublished - Dec 1 2018

Keywords

  • 21-Gene recurrence score
  • Breast cancer
  • Grade
  • Oncotype DX
  • Progesterone receptor

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