A Nomogram for Predicting the Oncotype DX Recurrence Score in Women with T1-3N0-1miM0 Hormone Receptor‒Positive, Human Epidermal Growth Factor 2 (HER2)‒Negative Breast Cancer
- Author:
Sae Byul LEE
1
;
Junetae KIM
;
Guiyun SOHN
;
Jisun KIM
;
Il Yong CHUNG
;
Hee Jeong KIM
;
Beom Seok KO
;
Byung Ho SON
;
Sei Hyun AHN
;
Jong Won LEE
;
Kyung Hae JUNG
Author Information
- Publication Type:Original Article
- Keywords: Breast neoplasms; Oncotype; Prognosis; Prediction; Nomogram; Recurrence
- MeSH: Breast Neoplasms; Breast; Chungcheongnam-do; Drug Therapy; Epidermal Growth Factor; Estrogens; Female; Humans; Humans; Logistic Models; Lymph Nodes; Multivariate Analysis; Neoplasm Micrometastasis; Nomograms; Prognosis; Receptors, Progesterone; Recurrence; Retrospective Studies; ROC Curve
- From:Cancer Research and Treatment 2019;51(3):1073-1085
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: This preliminary study was conducted to evaluate the association between Oncotype DX (ODX) recurrence score and traditional prognostic factors. We also developed a nomogram to predict subgroups with low ODX recurrence scores (less than 25) and to avoid additional chemotherapy treatments for those patients. MATERIALS AND METHODS: Clinicopathological and immunohistochemical variables were retrospectively retrieved and analyzed from a series of 485 T1-3N0-1miM0 hormone receptor-positive, human epidermal growth factor 2‒negative breast cancer patients with available ODX test results at Asan Medical Center from 2010 to 2016. One hundred twenty-seven patients (26%) had positive axillary lymph node micrometastases, and 408 (84%) had ODX recurrence scores of ≤25. Logistic regression was performed to build a nomogram for predicting a low-risk subgroup of the ODX assay. RESULTS: Multivariate analysis revealed that estrogen receptor (ER) score, progesterone receptor (PR) score, histologic grade, lymphovascular invasion (LVI), and Ki-67 had a statistically significant association with the low-risk subgroup. With these variables, we developed a nomogram to predict the low-risk subgroup with ODX recurrence scores of ≤25. The area under the receiver operating characteristic curve was 0.90 (95% confidence interval [CI], 0.85 to 0.96). When applied to the validation group the nomogram was accurate with an area under the curve = 0.88 (95% CI, 0.83 to 0.95). CONCLUSION: The low ODX recurrence score subgroup can be predicted by a nomogram incorporating five traditional prognostic factors: ER, PR, histologic grade, LVI, and Ki-67. Our nomogram, which predicts a low-risk ODX recurrence score, will be a useful tool to help select patients who may or may not need additional ODX testing.
