Prognostic Applications of Gene Expression Signatures in Breast Cancer

Normanno, Nicola; Luca, Antonella De; Carotenuto, Pietro; Lamura, Luana; Oliva, Ilaria; D’Alessio, Amelia

doi:10.1159/000258489

Cited by 19 publications

(12 citation statements)

References 69 publications

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“…Although molecular subtype did not show a significant DFS difference in multivariate analysis, the luminal A subtype showed more favorable survival than the other subtypes, similar to the findings of other studies. [21][22][23] In addition, in this study, DFS clearly differed according to the usage of trastuzumab in HER2-positive patients, as confirmed in other randomized trials. 11,12 Interestingly, the DFS of HER2-positive patients treated with trastuzumab was not different from that of the luminal A subtype (P ¼ .88); however, the lack of Ki-67 evaluation might compromise the survival of the luminal A subtype because some luminal B might have been categorized to luminal A in the present study.…”

Section: Discussionsupporting

confidence: 86%

Clinical Outcomes and Prognostic Factors of Pathologic N3 Breast Cancer Treated With Modern Standard Treatments

Park

Choi

et al. 2015

Clinical Breast Cancer

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Section: Discussionsupporting

confidence: 86%

Clinical Outcomes and Prognostic Factors of Pathologic N3 Breast Cancer Treated With Modern Standard Treatments

Park

Choi

et al. 2015

Clinical Breast Cancer

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“…High grade and large size has been shown to be of some prognostic relevance for local recurrence (EBCTCG) but we lack factors that predict risk for developing invasive cancer. In invasive cancer, molecular subtype has been shown to predict prognosis (Su [14], Normanno [15]) but very little data has been published regarding DCIS [10,16]. There are no publications using the proposed criteria from St Gallen, 2011(Goldhirsch, [1]) in DCIS.…”

Section: Discussionmentioning

confidence: 99%

Molecular subtypes in ductal carcinoma in situ of the breast and their relation to prognosis: a population-based cohort study

et al. 2013

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BackgroundDifferent molecular subtypes of breast cancer have been identified based on gene expression profiling. Treatment suggestions based on an approximation of these subtypes by immunohistochemical criteria have been published by the St Gallen international expert consensus panel. Ductal carcinoma in situ (DCIS) can be classified into the same molecular subtypes. Our aim was to study the relation between these newly defined subtypes and prognosis in DCIS.MethodsTMA including 458 women from a population-based cohort with DCIS diagnosed 1986–2004 was used. Stainings for ER, PR, HER2 and Ki67 were used to classify the surrogate molecular subtypes according to the St Gallen criteria from 2011. The associations with prognosis were examined using Kaplan-Meier analyses and Cox proportional hazards regression models.ResultsSurrogate molecular subtyping could be done in 381 cases. Mean follow up was 164 months. Of the classified DCIS 186 were Luminal A (48.8%), 33 Luminal B/HER2- (8.7%), 74 Luminal B/HER2+ (17.4%), 61 HER2+/ER- (16.0%) and 27 Triple Negative (7.1%). One hundred and two women had a local recurrence of which 58 were invasive. Twenty-two women had generalised disease, 8 without a prior local recurrence. We could not find a prognostic significance of the molecular subtypes other than a higher risk of developing breast cancer after more than 10 years of follow-up among women with a Triple Negative DCIS (OR 3.2; 95% CI 1.1-9.8).ConclusionsThe results from this large population-based cohort, with long-term follow up failed to demonstrate a prognostic value for the surrogate molecular subtyping of DCIS using the St Gallen criteria up to ten years after diagnosis. More than ten years after diagnosis Triple Negative DCIS had an elevated risk of recurrence.

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“…This molecular classification includes four main subtypes of breast cancer: luminal A subtype, luminal B subtype, human epidermal growth factor receptor 2 (HER2) subtype, and basal-like tumors [16]. Breast cancers have different clinical features according to their intrinsic subtypes, accordingly, they may have a different prognostic CTC value according to own subtype [17].…”

Section: Introductionmentioning

confidence: 99%

Circulating Tumor Cells Detected by RT-PCR for CK-20 before Surgery Indicate Worse Prognostic Impact in Triple-Negative and HER2 Subtype Breast Cancer

et al. 2012

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PurposeCirculating tumor cells (CTC) clearly correlate with unfavorable outcomes for patients with metastatic breast cancer, but the long-term prognostic implications of CTC for molecular subtypes of operable breast cancer are not yet known. We explored the relationships between previously established prognostic factors and CTC in operable breast cancer, and the significance of CTC by breast cancer molecular subtype.MethodsWe retrospectively evaluated 166 patients with operable breast cancer (stage I-IIIA) diagnosed from April 1997 to May 2003. CTC were detected using cytokeratin-20 (CK-20) mRNA expression in peripheral blood samples that were collected just prior to surgery under general anesthesia. Clinicopathological characteristics of the cancer were analyzed according to CTC status. Metastasis-free survival (MFS) and overall survival (OS) were analyzed according to CTC status and breast cancer molecular subtype.ResultsCK-20 mRNA-positive CTC was detected in 37 of 166 patients (22.3%) and was not correlated with any previous clinical factors in univariate analysis (p>0.05). After a median follow-up of 100 months, the patients with CK-20 mRNA-positive CTC had less favorable outcomes in terms of MFS and OS than those without detectable CTC (log-rank p<0.05). Among molecular subtypes of operable breast cancer, the patients with CK-20 mRNA-positive CTC had shorter MFS and OS in triple negative and human epidermal growth factor 2 (HER2) breast cancer subtype (log-rank, p<0.05).ConclusionCK-20 mRNA-positive CTC may lend insight into tumor progression as a prognostic indicator especially in the triple negative and HER2 subtypes of operable breast cancer.

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Prognostic Applications of Gene Expression Signatures in Breast Cancer

Cited by 19 publications

References 69 publications

Clinical Outcomes and Prognostic Factors of Pathologic N3 Breast Cancer Treated With Modern Standard Treatments

Clinical Outcomes and Prognostic Factors of Pathologic N3 Breast Cancer Treated With Modern Standard Treatments

Molecular subtypes in ductal carcinoma in situ of the breast and their relation to prognosis: a population-based cohort study

Circulating Tumor Cells Detected by RT-PCR for CK-20 before Surgery Indicate Worse Prognostic Impact in Triple-Negative and HER2 Subtype Breast Cancer

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