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Prognostic value of the 21-gene recurrence score for regional recurrence in patients with estrogen receptor-positive breast cancer

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Abstract

Purpose

To evaluate the prognostic value of the 21-gene recurrence score (RS) for regional recurrence (RR) in patients with estrogen receptor-positive breast cancer.

Methods

We reviewed the medical records of 446 patients who underwent 21-gene RS assay after breast-conserving surgery or mastectomy. The high-RS group was defined as patients who were (1) older than 50 years with an RS of 26 or higher, or (2) 50 years or younger with an RS of 16 or higher.

Results

The 5-year rates of local recurrence (LR), RR, and distant metastasis (DM) were 2.2%, 2.7%, and 4.7%, respectively. The 5-year overall survival (OS) rate was 99.1%. Of the patients, 269 (60.3%) had low-RS, while 177 (39.7%) had high-RS. The 5-year OS rate of the high-RS group was significantly lower than that of the low-RS. The 5-year rates of RR and DM in the high-RS group were significantly higher than those in the low-RS group, while the LR rates did not differ significantly. In multivariable analysis, the high-RS group had a significant relationship with increased RR rate (p = 0.037). Patients who had both high-RS and clinical high-risk features had a significantly higher 5-year RR rate (7.9%) compared with other groups.

Conclusions

High-RS was an independent risk factor for RR. The significantly higher RR rate of patients with both high-RS and clinical high-risk features compared with other groups suggests that this patient group can be a potential candidate for regional nodal irradiation.

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Data availability

The datasets generated and/or analyzed during the current study are not publicly available due to legal issues.

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Acknowledgements

We thank Dr. Joon Seo Lim from the Scientific Publications Team at Asan Medical Center for his editorial assistance in preparing this manuscript.

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Authors and Affiliations

  1. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Minji Koh, Jinhong Jung, Su Ssan Kim, Seung Do Ahn & Eun Kyung Choi

  2. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Il Yong Chung & Jong Won Lee

  3. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Sung-Bae Kim & Jae Ho Jeong

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  1. Minji Koh
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  3. Su Ssan Kim
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Contributions

Study concept and design: JJ, JHJ, MK; provision of study materials and patients: JJ, JHJ, SSK, SDA, EKC, IYC, JWL, SK; collection and assembly of data: JJ, JHJ, MK, IYC, JWL; Data analysis and interpretation: JJ, JHJ, MK; manuscript writing: JJ, JHJ, MK, SSK, IYC, JWL, SK. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jinhong Jung or Jae Ho Jeong.

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The authors declare that they have no conflict of interest.

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Ethics approval for this study was obtained through the Institutional Review Board of Asan Medical Center. Considering the retrospective nature of the study, informed written consent was waived according to the rule of the review board.

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Koh, M., Jung, J., Kim, S.S. et al. Prognostic value of the 21-gene recurrence score for regional recurrence in patients with estrogen receptor-positive breast cancer. Breast Cancer Res Treat 188, 583–592 (2021). https://doi.org/10.1007/s10549-021-06228-1

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