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KMID : 1134120230260020105
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Journal of Breast Cancer
2023 Volume.26 No. 2 p.105 ~ p.116
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Prediction of Oncotype DX Recurrence Score Using Clinicopathological Variables in Estrogen Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer
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Kim Min-Chong
Kwon Sun-Young
Choi Jung-Eun
Kang Su-Hwan
Bae Young-Kyung
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Abstract
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Purpose : Oncotype DX (ODX) is a well-validated multigene assay that is increasingly used in Korean clinical practice. This study aimed to develop a clinicopathological prediction (CPP) model for the ODX recurrence scores (RSs).
Methods : A total of 297 patients (study group, n = 175; external validation group, n = 122) with estrogen receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, T1-3N0-1M0 breast cancer, and available ODX test results were included in the study. Risk categorization as determined by ODX RSs concurred with the TAILORx study (low-risk, RS ≤ 25; high-risk, RS > 25). Univariate and multivariate logistic regression analyses were used to assess the relationships between clinicopathological variables and risk stratified by the ODX RSs. A CPP model was constructed based on regression coefficients (β values) for clinicopathological variables significant by multivariate regression analysis.
Results : Progesterone receptor (PR) negativity, high Ki-67 index, and nuclear grade (NG) 3 independently predicted high-risk RS, and these variables were used to construct the CPP model. The C-index, which represented the discriminatory ability of our CPP model for predicting a high-risk RS, was 0.915 (95% confidence interval [CI], 0.859?0.971). When the CPP model was applied to the external validation group, the C-index was 0.926 (95% CI, 0.873?0.978).
Conclusion : Our CPP model based on PR, Ki-67 index, and NG could aid in the selection of patients with breast cancer requiring an ODX test.
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KEYWORD
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Breast Neoplasms, Drug Therapy, Ki-67 Antigen, Receptors, Progesterone, Recurrence
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