Li Liangqiang, Yu Jing, Shen Kunwei, Chen Xiaosong
Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Breast Surgery, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian, China.
J Breast Cancer. 2024 Jun;27(3):163-175. doi: 10.4048/jbc.2023.0248. Epub 2024 Apr 11.
The 21-gene recurrence score (RS) can guide adjuvant chemotherapy decisions in the multidisciplinary treatment (MDT) of patients with early breast cancer. This study aimed to evaluate the influence of the 21-gene RS assay on patient' compliance with MDT and its association with disease outcomes.
Patients diagnosed with pN0-1, hormone receptor-positive, human epidermal growth factor receptor-2-negative breast cancer between January 2013 and June 2019 were enrolled. A logistic regression model was used to identify parameters associated with treatment adherence. Prognostic indicators were evaluated using the Cox proportional hazard models.
After the assay, patients were less likely to violate the treatment plan (14.9% vs. 23.1%, < 0.001), and higher compliance rates were observed for chemotherapy ( = 0.042), radiotherapy ( = 0.012), and endocrine therapy ( < 0.001). Multivariable analysis demonstrated that the 21-gene RS assay (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.09-1.88; = 0.009) was independently associated with MDT compliance. Moreover, compliance with MDT was independently associated with better disease-free survival (hazard ratio, 0.43; 95% CI, 0.29-0.64; < 0.001), regardless of the 21-gene RS assay (interaction = 0.842).
The 21-gene RS assay improved the MDT compliance rate in patients with early breast cancer. Adherence to MDT is associated with a better prognosis.
21基因复发评分（RS）可指导早期乳腺癌患者多学科治疗（MDT）中的辅助化疗决策。本研究旨在评估21基因RS检测对患者MDT依从性的影响及其与疾病转归的关联。
纳入2013年1月至2019年6月期间诊断为pN0-1、激素受体阳性、人表皮生长因子受体-2阴性乳腺癌的患者。采用逻辑回归模型确定与治疗依从性相关的参数。使用Cox比例风险模型评估预后指标。
检测后，患者违反治疗计划的可能性降低（14.9%对23.1%，<0.001），化疗（=0.042）、放疗（=0.012）和内分泌治疗（<0.001）的依从率更高。多变量分析表明，21基因RS检测（优势比[OR]，1.43；95%置信区间[CI]，1.09-1.88；=0.009）与MDT依从性独立相关。此外，无论21基因RS检测结果如何（交互作用=0.842），MDT依从性与更好地无病生存独立相关（风险比，0.43；95%CI，0.29-0.64；<0.001）。
21基因RS检测提高了早期乳腺癌患者的MDT依从率。坚持MDT与更好的预后相关。
