21-gene recurrence assay in patients receiving intraoperative radiotherapy: are “favorable” characteristics a surrogate for low recurrence?

Oppong, Bridget A.; Gupta, Surupa Sen; Gary, Monique; Wehner, Patricia; Zhao, Danjing; Seevaratnam, Sulakshana; Rudra, Sonali; Willey, Shawna C.

doi:10.21037/gs.2017.07.05

Cited by 2 publications

(2 citation statements)

References 23 publications

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“…In prior studies of all breast cancer patients, high RS has been most closely associated with tumor grade and progesterone receptor status, although age, T stage, and lymphovascular invasion are also linked to increased RS (11,12). The IORT patients in our study have a better RS profile compared to the national trends, and are in keeping with those documented in a prior publication on IORT patients (13). Low risk (53%) and intermediate risk (44%) scores are more common in IORT patients, whereas high risk score (3%) is far less common.…”

Section: Discussionsupporting

confidence: 86%

Oncotype testing in patients undergoing intraoperative radiation for breast cancer

et al. 2018

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Oncotype DX recurrence score (RS) predicts risk of distant disease recurrence, and can guide chemotherapy recommendations in hormone positive, human epidermal growth factor 2-negative, early stage breast cancer. The present study aimed to evaluate the pattern of oncotype testing, RS and adjuvant treatment in patients undergoing intraoperative radiotherapy (IORT). Single center prospective data registry was queried for patients receiving IORT between October 2011 and February 2017. Patient demographics, tumor characteristics, RS, systemic therapy and recurrence information were analyzed. A total of 150 women with mean age of 70.8 years were included. The majority had invasive ductal cancer (60.6%) with 1.0 cm average tumor size and no lymph node involvement (99%). Oncotype testing was performed in 36 patients (24.3%). Low risk score (<18) was confirmed in 19 women (53%); intermediate risk score (18-30) in 16 women (44%); and high risk score (>30) in one woman (3%). Patients with RS testing had significantly increased tumor sizes (1.2 vs. 1.0 cm; P<0.001) and were younger (68.5 vs. 71.3 years; P=0.02) compared with those not tested. A total of 4/150 patients (2.6%) received chemotherapy; two received chemotherapy based on RS testing. Based on the current selection criteria for IORT, oncotype testing rarely results in a high-risk score or utilization of chemotherapy for IORT patients. The present study supports selective use of RS testing in IORT patients and confirms that biologically low-risk patients are being selected for IORT based on current guidelines.

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Section: Discussionsupporting

confidence: 86%

Oncotype testing in patients undergoing intraoperative radiation for breast cancer

et al. 2018

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“…Patients for whom the 21‐gene Oncotype DX Breast Cancer assay was ordered were more likely to have a higher tumor grade, higher pathologic stage, and higher rate of additional whole‐breast EBRT and adjuvant chemotherapy. This finding is supported by the study of Oppong et al who found that most of their 82 IORT‐treated patients with early breast cancer who were selected for IORT on the basis of clinical features were indeed low‐risk based on the Recurrence Score.…”

Section: Discussionsupporting

confidence: 53%

Intraoperative radiation therapy for breast cancer—Immediate and 30‐month oncological outcomes

et al. 2019

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There is growing evidence that intraoperative radiation therapy (IORT) may be a viable option in selected patients with early breast cancer. This study reports our 4-year experience with IORT. The perioperative outcome and imaging data of all patients who underwent IORT for early breast cancer at a tertiary medical center in 2014-2018 were retrospectively retrieved. The cohort included 158 patients aged 52-84 years (mean 68) with stage I (n = 137) or II (n = 21) breast cancer. Mean applicator size was 4.13 cm; IORT added a mean of 29 minutes to the operative time.Minor wound infections (n = 18, 11.4%) requiring antibiotics and drainage were the only postoperative complication. In 25 patients (15%), postoperative mammography demonstrated a seroma (n = 22) or fat necrosis (n = 3). The risk of wound infection or a new postoperative imaging finding was unrelated to patient age, operative time, tumor size, or comorbid diabetes or obesity. After a mean of 30 months' follow-up, none of the patients who met the institutional criteria for IORT had local recurrence, regardless of age, histology, tumor grade, KI67 proliferation index, pathologic stage, Recurrence Score, or additional whole-breast irradiation or adjuvant treatment.Patients for whom a Recurrence Score was determined (n = 55, 35%) had a significantly higher tumor grade, pathologic stage, and whole-breast irradiation/adjuvant chemotherapy rate than the remaining patients. IORT may be a safe alternative to traditional external beam radiation in well-selected patients with early breast cancer, with few minor complications and good 30-month outcome. K E Y W O R D Searly breast cancer, electronic brachytherapy, intraoperative radiation, radiation, Recurrence Score, targeted radiotherapy | 947 MELNIK Et aL.

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21-gene recurrence assay in patients receiving intraoperative radiotherapy: are “favorable” characteristics a surrogate for low recurrence?

Cited by 2 publications

References 23 publications

Oncotype testing in patients undergoing intraoperative radiation for breast cancer

Oncotype testing in patients undergoing intraoperative radiation for breast cancer

Intraoperative radiation therapy for breast cancer—Immediate and 30‐month oncological outcomes

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