Cheung Polly S Y, Tong Adam C, Leung Roland C Y, Kwan W H, Yau Thomas C C
Breast Care Centre, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong.
St George's University of London, St George's Healthcare Trust, Cranmer Terrace, London SW17 0RE, United Kingdom.
Hong Kong Med J. 2014 Oct;20(5):401-6. doi: 10.12809/hkmj134140. Epub 2014 Jun 20.
To examine the impact of the 21-gene Oncotype DX Breast Cancer Assay on the adjuvant treatment decision-making process for early-stage breast cancer in Hong Kong.
Retrospective study.
Private hospital, Hong Kong.
Study included cases of early-stage breast cancer (T1-2N0-1M0, oestrogen receptor-positive, human epidermal growth factor receptor 2-negative) that were presented at a multidisciplinary breast meeting at a single site. Cases were selected for Oncotype DX testing with the assistance of Adjuvant! Online. The recommendations for adjuvant therapy before and after obtaining the Oncotype DX Recurrence Score results were analysed.
A total of 154 cases that met the inclusion criteria were discussed at our multidisciplinary breast meeting. Of these, 64 cases with no clear recommendation by the Meeting Panel were selected for this study and reviewed. The distribution of Recurrence Score results was similar to that reported by others, with a somewhat higher proportion of low Recurrence Scores. Treatment recommendation was changed for 20 (31%) patients after the Oncotype DX result was received. Of the changes in treatment decisions, 16 (80%) were changes to lower-intensity regimens (either equipoise or hormonal therapy). The number of cases receiving an equipoise recommendation decreased by nine (82%), based on the additional information provided by the Oncotype DX test.
The Oncotype DX Recurrence Score information impacts the decision-making process for adjuvant therapy for early-stage breast cancer in the multidisciplinary care setting in Hong Kong. A larger-scale study is required to gain more experience, evaluate its impact more thoroughly, and assess its cost-effectiveness.
探讨21基因Oncotype DX乳腺癌检测对香港早期乳腺癌辅助治疗决策过程的影响。
回顾性研究。
香港私立医院。
研究纳入在单一地点的多学科乳腺会议上报告的早期乳腺癌（T1-2N0-1M0，雌激素受体阳性，人表皮生长因子受体2阴性）病例。在Adjuvant! Online的协助下选择病例进行Oncotype DX检测。分析获得Oncotype DX复发评分结果前后辅助治疗的建议。
在我们的多学科乳腺会议上共讨论了154例符合纳入标准的病例。其中，64例会议小组未给出明确建议的病例被选入本研究并进行回顾。复发评分结果的分布与其他人报告的相似，低复发评分的比例略高。收到Oncotype DX结果后，20例（31%）患者的治疗建议发生了改变。在治疗决策的改变中，16例（80%）是改为强度较低的方案（平衡或激素治疗）。根据Oncotype DX检测提供的额外信息，接受平衡建议的病例数减少了9例（82%）。
Oncotype DX复发评分信息影响香港多学科护理环境中早期乳腺癌辅助治疗的决策过程。需要进行更大规模的研究以获得更多经验，更全面地评估其影响，并评估其成本效益。
