Hartmann Steffi, Gerber Bernd, Elling Dirk, Heintze Kristin, Reimer Toralf
Department of Obstetrics and Gynecology, University of Rostock, Germany.
Breast Care (Basel). 2012 Feb;7(1):19-24. doi: 10.1159/000336552. Epub 2012 Feb 13.
The aim of this article was to evaluate the prognostic value of the MammaPrint(TM) signature in women $$ 60 years with invasive breast cancer. PATIENTS AND METHODS: 60 female patients were included in this prospective study. Eligibility criteria included: pT1c-3, pN0-1a, grade 2/3, hormone receptor-positive and HER2-negative tumor. The clinical risk was determined by Adjuvant! Online (AOL). RESULTS: 38 patients (63%) where considered to be low-risk patients by the 70-gene signature, while 22 (37%) were considered to be high-risk patients. No statistically significant differences between low- and high-risk groups could be detected for conventional prognostic parameters, particularly not for Ki-67. By AOL, 33 patients (55%) were considered to be at high risk, of which 20 had a discordant MammaPrint(TM) result. The discordance rate between the profile and AOL was 48%, which is higher than in previous publications. When the 70-gene signature was used in combination with the clinical risk assessment, the recommendation for adjuvant systemic treatment differed in 11 patients (18%). CONCLUSIONS: In the intermediate-risk subgroup, the 70-gene signature could be useful to decide in elderly patients whether they may benefit from adjuvant chemotherapy or not. Conventional clinicopathological factors were not suitable for a prediction of the 70-gene signature results in these patients.
本文旨在评估MammaPrint™基因特征对60岁及以上浸润性乳腺癌女性患者的预后价值。
本前瞻性研究纳入了60例女性患者。纳入标准包括：pT1c - 3、pN0 - 1a、2/3级、激素受体阳性且HER2阴性的肿瘤。临床风险由辅助治疗在线工具（AOL）确定。
70基因特征显示，38例患者（63%）被认为是低风险患者，而22例（37%）被认为是高风险患者。在传统预后参数方面，低风险和高风险组之间未检测到统计学上的显著差异，尤其是Ki - 67。根据AOL，33例患者（55%）被认为处于高风险，其中20例MammaPrint™结果不一致。基因特征与AOL之间的不一致率为48%，高于以往报道。当70基因特征与临床风险评估联合使用时，辅助全身治疗的建议在11例患者（18%）中有所不同。
在中度风险亚组中，70基因特征可能有助于决定老年患者是否能从辅助化疗中获益。传统的临床病理因素不适用于预测这些患者的70基因特征结果。
