21‐gene expression assay and clinical outcomes of premenopausal patients with hormone receptor‐positive breast cancer

Author:

Hyung Jaewon1ORCID,Lee Sae Byul2,Kim Jisun2,Kim Hee Jeong2,Ko BeomSeok2,Lee Jong Won2,Son Byung‐Ho2,Lee Hee Jin3,Gong Gyungyub3,Jeong Hyehyun1,Jeong Jae Ho1,Kim Jeong Eun1,Ahn Jin‐Hee1,Jung Kyung Hae1,Kim Sung‐Bae1ORCID

Affiliation:

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

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

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

Abstract

AbstractThe prognostic role of the recurrence score (RS) based on the 21‐gene expression assay in premenopausal women is not well delineated, and we investigated the association of outcomes and the RS in premenopausal patients who had 21‐gene expression assay at Asan Medical Center, Seoul, Korea, between June 2005 and July 2018. Invasive breast cancer‐free survival (IBCFS) by STEEP version 2.0 was compared according to the RS and clinical risk factors. A total of 554 patients were included in our study and 116 patients (20.9%) had age <40 years, 238 patients (43.0%) had luminal B subtype (Ki67 ≥ 20%), and 83 patients (15.0%) had RS >25. All patients received adjuvant tamoxifen ± chemotherapy. Overall, patients with RS >25 showed trend toward worse IBCFS from multivariable analysis (adjusted HR 1.89 [95% CI: 0.95‐3.73], P = .069). When comparing outcomes according to age and luminal subtypes, patients with luminal B subtype and age <40 years (n = 60) showed significantly worse outcomes compared to the others (luminal A or luminal B + age ≥40 years, n = 494; adjusted HR 2.95 [95% CI: 1.49‐5.82], log‐rank P < .001). Among patients with luminal B subtype and age <40 years, there was no significant association observed between IBCFS and the RS (log‐rank P = .51). In conclusion, while RS >25 showed association with poor outcomes in premenopausal women, it may have less prognostic significance among those with luminal B subtype and age <40 years.

Publisher

Wiley

Subject

Cancer Research,Oncology

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