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Concordance Between 21-Gene Recurrence Scores in Multifocal or Multicentric Breast Carcinomas Differs by Age and Histologic Subtype

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Among patients with multifocal or multicentric (MF/MC) breast cancer (BC) of similar morphology, concordance in Oncotype DX recurrence scores (RS) between tumors has been reported to be 87%. The effect of age and variation in histologic subtypes on RS concordance according to TAILORx criteria is unknown.

Methods

We identified patients with MF/MC, estrogen receptor-positive, HER2-negative, node-negative BC with two or more RS results treated at our institution from 2009 to 2018. Patients were analyzed by age group (≤ 50 and > 50 years). Low- and high-risk cut-offs were RS ≤ 25 and > 25 for age > 50 years, and RS ≤ 20 and > 20 for age ≤ 50 years. RS concordance was defined as no change in management based on RS variation between lesions.

Results

Overall, 120 patients with MF/MC BC were identified—82 (68.3%) aged > 50 years and 38 (31.7%) aged ≤ 50 years. Patients aged ≤ 50 years had higher mean RS for both multifocal (20 vs. 14; p = 0.006) and multicentric (17 vs. 13; p = 0.003) tumors and more frequently had high-risk tumors (p < 0.0001). Among patients aged > 50 years, 95.1% had RS concordance between tumors (same subtype, 98.2%; variable subtype, 88.9%; p = 0.1). Among patients aged ≤ 50 years, RS concordance was 81.6%.

Conclusions

Among patients with MF/MC BC, RS concordance was high, particularly in those aged > 50 years with tumors of the same histologic subtype. RS testing of one focus may be sufficiently prognostic and predictive in patients aged > 50 years, regardless of subtype concordance. Testing of individual foci should be considered in patients aged ≤ 50 years due to a higher likelihood of RS discordance.

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Funding

This work was supported in part by NIH/NCI Cancer Center Support Grant P30 CA008748.

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Authors and Affiliations

  1. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Kate R. Pawloski MD, Audree B. Tadros MD, MPH, Kelly Abbate BS, Monica Morrow MD & Mahmoud El-Tamer MD, FACS

  2. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Hannah Y. Wen MD, PhD

Authors
  1. Kate R. Pawloski MD
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  2. Hannah Y. Wen MD, PhD
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  3. Audree B. Tadros MD, MPH
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  4. Kelly Abbate BS
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  5. Monica Morrow MD
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  6. Mahmoud El-Tamer MD, FACS
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Corresponding author

Correspondence to Mahmoud El-Tamer MD, FACS.

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Disclosures

Kate R. Pawloski, Hannah Y. Wen, Audree B. Tadros, Kelly Abbate, and Mahmoud El-Tamer declare they have no conflicts of interest. Monica Morrow declares the receipt of speaking honoraria from Genomic Health.

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Pawloski, K.R., Wen, H.Y., Tadros, A.B. et al. Concordance Between 21-Gene Recurrence Scores in Multifocal or Multicentric Breast Carcinomas Differs by Age and Histologic Subtype. Ann Surg Oncol 28, 4256–4262 (2021). https://doi.org/10.1245/s10434-020-09429-y

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