Pohl Heinrich, Kotze Maritha J, Grant Kathleen A, van der Merwe Lize, Pienaar Fredrieka M, Apffelstaedt Justus P, Myburgh Ettienne J
Department of Surgery, University of Stellenbosch, Tygerberg, South Africa.
Division of Anatomical Pathology, Department of Pathology, Faculty of Medicine and Health Sciences, University of Stellenbosch, Tygerberg, South Africa.
Breast J. 2016 Jul;22(4):442-6. doi: 10.1111/tbj.12605. Epub 2016 Apr 14.
The aim of the study was to evaluate the impact of MammaPrint on treatment decision-making in patients with breast cancer. Clinicopathologic information of all breast cancer patients referred for MammaPrint testing in South Africa was collected from 2007 until 2014. A total of 107 patients (109 tumors) with estrogen receptor/progesterone receptor positive and human epidermal growth factor receptor-2 negative tumors were selected with tumors ≥10 mm, or when 1-3 nodes were involved without extra-nodal extension. None of the clinical indicators correlated significantly with the MammaPrint risk classification, which changed the decision for adjuvant chemotherapy in 52% of patients. Of 60 patients who were clinically high risk, 62% had a low-risk MammaPrint result and of the 47 clinically low -risk patients 40% had a high-risk MammaPrint result. This study indicates that MammaPrint could reduce the need for adjuvant chemotherapy by 17% using the selection criteria stipulated. The significant impact on treatment decisions confirmed the clinical utility of MammaPrint independent of standard clinicopathologic risk factors as supported by long-term clinical outcome studies.
本研究的目的是评估MammaPrint对乳腺癌患者治疗决策的影响。收集了2007年至2014年期间在南非因MammaPrint检测而转诊的所有乳腺癌患者的临床病理信息。共选择了107例患者（109个肿瘤），这些患者的肿瘤雌激素受体/孕激素受体阳性且人表皮生长因子受体2阴性，肿瘤≥10 mm，或有1 - 3个淋巴结受累且无结外扩展。没有任何临床指标与MammaPrint风险分类显著相关，MammaPrint改变了52%患者的辅助化疗决策。在60例临床高危患者中，62%的MammaPrint结果为低风险；在47例临床低危患者中，40%的MammaPrint结果为高风险。本研究表明，按照规定的选择标准，MammaPrint可使辅助化疗的需求减少17%。对治疗决策的显著影响证实了MammaPrint的临床实用性，长期临床结局研究支持其独立于标准临床病理风险因素。
