Prognostic Value of the Detection of Lymphovascular Invasion in Hormone Receptor-Positive Early Breast Cancer in the Era of Molecular Profiling.
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor
Breast Neoplasms
/ genetics
Chemotherapy, Adjuvant
Female
Humans
Kaplan-Meier Estimate
Lymphatic Metastasis
Middle Aged
Neoplasm Invasiveness
Receptor, ErbB-2
/ genetics
Receptors, Estrogen
/ genetics
Receptors, Progesterone
Retrospective Studies
Treatment Outcome
Tumor Burden
Disease-free survival
Invasive breast cancer
Lymphovascular invasion
Oncotype DX Recurrence Score
Overall survival
Prognostic factors
Journal
Oncology
ISSN: 1423-0232
Titre abrégé: Oncology
Pays: Switzerland
ID NLM: 0135054
Informations de publication
Date de publication:
2019
2019
Historique:
received:
16
05
2018
accepted:
24
07
2018
pubmed:
27
9
2018
medline:
1
1
2019
entrez:
26
9
2018
Statut:
ppublish
Résumé
Lymphovascular invasion (LVI) is considered a negative prognostic factor in early breast cancer, but its role in decision-making regarding adjuvant chemotherapy is unclear in the current era of molecular profiling. This study sought to evaluate the association of LVI status with the recurrence score (RS) on the multigene Oncotype DX (ODX) assay and its impact on outcome. Patients with early estrogen receptor-positive breast cancer who underwent ODX analysis in 2005-2012 were retrospectively identified. Clinical data were collected from the medical records. The Cox proportional-hazards ratio was used to determine recurrence rates. The prognostic significance of LVI was evaluated by competing risks analysis. LVI was detected in 38 of 657 patients (6%). LVI was not associated with ODX RS (p = 0.225). However, it was significantly associated with other known prognostic factors and with worse 5-year disease-free survival (HR 2.93; 95% CI 1.02-8.39; p = 0.04). Overall survival (OS) analysis according to the ODX subgroups showed that the presence of LVI was associated with worse 5-year OS (p = 0.04) only in the intermediate-risk group, while LVI had no effect on the low- or high-risk groups. Although LVI was not significantly associated with a higher ODX RS, it may infer a worse outcome, especially in ODX intermediate-risk patients.
Sections du résumé
BACKGROUND
BACKGROUND
Lymphovascular invasion (LVI) is considered a negative prognostic factor in early breast cancer, but its role in decision-making regarding adjuvant chemotherapy is unclear in the current era of molecular profiling. This study sought to evaluate the association of LVI status with the recurrence score (RS) on the multigene Oncotype DX (ODX) assay and its impact on outcome.
METHODS
METHODS
Patients with early estrogen receptor-positive breast cancer who underwent ODX analysis in 2005-2012 were retrospectively identified. Clinical data were collected from the medical records. The Cox proportional-hazards ratio was used to determine recurrence rates. The prognostic significance of LVI was evaluated by competing risks analysis.
RESULTS
RESULTS
LVI was detected in 38 of 657 patients (6%). LVI was not associated with ODX RS (p = 0.225). However, it was significantly associated with other known prognostic factors and with worse 5-year disease-free survival (HR 2.93; 95% CI 1.02-8.39; p = 0.04). Overall survival (OS) analysis according to the ODX subgroups showed that the presence of LVI was associated with worse 5-year OS (p = 0.04) only in the intermediate-risk group, while LVI had no effect on the low- or high-risk groups.
CONCLUSIONS
CONCLUSIONS
Although LVI was not significantly associated with a higher ODX RS, it may infer a worse outcome, especially in ODX intermediate-risk patients.
Identifiants
pubmed: 30253418
pii: 000492429
doi: 10.1159/000492429
doi:
Substances chimiques
Biomarkers, Tumor
0
Receptors, Estrogen
0
Receptors, Progesterone
0
Receptor, ErbB-2
EC 2.7.10.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
14-24Informations de copyright
© 2018 S. Karger AG, Basel.