Prognosis analysis and 21-gene recurrence score assay applied in hormone receptor positive T1-3N1M0 breast cancer patients
10.3760/cma.j.cn112152-20250205-00039
- VernacularTitle:激素受体阳性T1～3N1M0期乳腺癌21基因复发风险评分与预后关系的真实世界研究
- Author:
Yanna ZHANG
1
;
Yang QU
1
;
Feng MAO
1
;
Li PENG
1
;
Qiang SUN
1
;
Yidong ZHOU
1
Author Information
1. 中国医学科学院北京协和医学院北京协和医院乳腺外科，北京100730
- Publication Type:Journal Article
- Keywords:
Breast neoplasms;
Hormone receptor;
Axillary lymph node;
Prognosis;
21-gene assay;
Recurrence score
- From:
Chinese Journal of Oncology
2025;47(11):1118-1125
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the association of 21-gene recurrence score (RS) and clinicopathologic characteristics of hormone receptor (HR) positive T1-3N1M0 breast cancer and its value in prognosis evaluation.Methods:The clinicopathological data of 287 patients with T1-3N1M0 breast cancer were collected, the 21-gene assay was completed, and follow-up was conducted. According to the 21-gene RS, the patients were divided into the RS<26 and RS≥26 groups. The relationship between the 21-gene RS and clinicopathological characteristics, treatment, recurrence, and metastasis was analyzed. Univariate and multivariate statistical analyses were used to analyze the risk factors for disease free survival (DFS).Results:The median RS of the 287 patients was 16. There were 240 cases with RS <26 and 47 cases with RS≥26. Tumor size, grade, estrogen receptor (ER), progesterone receptor (PR), and Ki-67 index were significantly different between the two cohorts ( P<0.05 for all). After a median follow-up of 74 months, the recurrence rate in the RS<26 group (8.3%) was significantly lower than that in the RS≥26 group (23.4%), the locoregional recurrence (LRR) rates in the RS<26 and RS≥26 groups were 2.1% and 0%,and the distant metastasis (DM) rates were 6.3% and 23.4%, respectively. The 5-year relapse free survival (RFS) rates of patients with RS<26 and RS≥26 were 93.8% (95% CI: 90.7%-96.9%) and 87.2% (95% CI: 78.2%-97.3%), and the 5-year DFS rates were 92.1% (95% CI: 88.7%-95.6%) and 85.1% (95% CI: 75.5%-95.9%), respectively, with significant differences between the two cohorts ( P=0.007 and P=0.006, respectively). Univariate analysis showed age, tumor size, grade, PR status, Ki-67 index and RS were prognostic factors for DFS ( P<0.05 for all). Multivariate analysis showed that age and tumor size were independent significant predictors for DFS ( P<0.05). Conclusions:The 21-gene RS of T1-3N1M0 breast cancer is related to tumor size, grade, ER, PR, and Ki-67 index. RS is an important factor affecting DM and DFS.
