Kezban Nur Pilanci1, Caglar Unal2, Cetin Ordu2, Erhan Gokmen3, Mustafa Ozdogan4, Nilufer Guler5, Cihan Uras6, Orhan Demircan7, Abdurrahman Isikdogan8, Halil Kara6, Abdullah Bahadir Oz9, Gul Alco10, Pinar Saip11, Yesim Eralp11, Vahit Ozmen12
1Division of Medical Oncology, Department of Internal Medicine, Memorial Bahçelievler Hospital, Istanbul, Turkey.
2Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey.
3Division of Medical Oncology, Department of Internal Medicine, Ege University School of Medicine, Izmir, Turkey.
4Division of Medical Oncology, Department of Internal Medicine, Akdeniz University School of Medicine, Antalya, Turkey.
5Division of Medical Oncology, Department of Internal Medicine, Hacettepe University Institute of Oncology, Ankara, Turkey.
6Department of General Surgery, Acibadem University, Istanbul, Turkey.
7Department of General Surgery, Cukurova University School of Medicine, Adana, Turkey.
8Division of Medical Oncology, Department of Internal Medicine, Dicle University School of Medicine, Diyarbakir, Turkey.
9Department of General Surgery, Erciyes University School of Medicine, Kayseri, Turkey.
10Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey.
11Department of Medicine, Division of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey.
12Department of General Surgery, Istanbul University Istanbul School of Medicine, Istanbul, Turkey.
Summary
Purpose: The Oncotype DX 21-gene recurrence score (RS) is widely used to determine prognosis and guide adjuvant therapy decisions for patients with estrogen receptor (ER)-positive, human epidermal growth factor 2 (HER2)-negative, early-stage breast cancer. However, its use is limited in Turkey due to cost, with therapy decisions often based on clinicopathologic factors. This study aimed to classify Oncotype DX RS according to the TAILORx risk category in early-stage breast cancer patients and correlate it with clinicopathologic characteristics.
Methods: Oncotype DX RS was retrospectively classified according to TAILORx risk categorization and compared with clinicopathologic characteristics in 196 patients with ER-positive, HER2-negative, early-stage breast cancer.
Results: 81.6% of patients had an Oncotype DX RS ≥ 11. Among patients with low recurrence scores (< 11), 75% had Luminal A and 25% had Luminal B molecular subtypes. Univariate analysis showed significant correlations between young age (< 50 years), low progesterone receptor (PR) immunoreactivity (≤ 20%), high Ki-67 (≥ 14) values, and high RS (≥ 11). Multivariate analysis found correlations between high RS (≥ 11), young age, and low PR immunoreactivity. There was a significantly reverse correlation between age and RS.
Conclusions: A significant correlation was found between RS ≥ 11 according to TAILORx risk categorization and low PR immunoreactivity (≤ 20%) and young age (< 50 years) as classic clinicopathologic factors. While clinicopathologic parameters alone may not be sufficient to determine treatment decisions in the absence of Oncotype DX testing, they may have a supportive role.
Keywords: early-stage breast cancer, clinicopathologic characteristics, Oncotype DX recurrence score, TAILORx risk categorization.
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