Factors associated with chemotherapy benefit in breast cancer patients with midrange oncotype DX breast recurrence scores.

2021 
Abstract Chemotherapy for breast cancer patients with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-negative, and with the midrange Oncotype DX breast recurrence scores (RS) still needs to be further individualized. To improve the treatment decision making, we aimed to develop a method that provides a single score based on multiple factors. We analyzed the Surveillance, Epidemiology, and End Results (SEER) registry data from 31,731 hormone receptor-positive, HER2-negative, node-negative breast cancer patients with the midrange RS characterized by sociodemographic (age and marital status) and clinicopathologic (tumor size, histologic grade, progesterone receptor status, broad histological classification, lesion laterality, and lesion overlap) features and stratified by RS ranges. Overall survival (OS) was compared between patients receiving chemotherapy and patients not receiving chemotherapy (or treatment status was unknown) within each RS stratum, for the entire sample and for each characteristic. There was no association between chemotherapy and survival in patients with RS = 11–15 for any characteristic. For patients with RS = 16–25, a chemotherapy benefit was associate with multiple factors, including tumor size, histologic grade, progesterone receptor status, histological type, and lesion laterality. In addition, overlapping lesion of breast and married at diagnosis might also provide additional predictive information of chemotherapy benefit when RS = 21–25. A simple and effective algorithm was designed by combining these factors to output a novel personalized chemotherapy benefit score (CBS). The CBS could effectively identify the subgroups of patients with RS = 16–25 who would most likely benefit from chemotherapy, and might facilitate improved treatment by providing individualized recommendations.
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