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Annals of Surgical Oncology

, Volume 26, Issue 3, pp 815–820 | Cite as

OncotypeDX Recurrence Score Does Not Predict Nodal Burden in Clinically Node Negative Breast Cancer Patients

  • S. E. Tevis
  • R. Bassett
  • I. Bedrosian
  • C. H. Barcenas
  • D. M. Black
  • A. S. Caudle
  • S. M. DeSnyder
  • E. Fitzsullivan
  • K. K. Hunt
  • H. M. Kuerer
  • A. Lucci
  • F. Meric-Bernstam
  • E. A. Mittendorf
  • K. Park
  • M. Teshome
  • A. M. Thompson
  • R. F. HwangEmail author
Breast Oncology
  • 124 Downloads

Abstract

Background

OncotypeDX recurrence score (RS)® has been found to predict recurrence and disease-free survival in patients with node negative breast cancer. Whether RS is useful in guiding locoregional therapy decisions is unclear. We sought to evaluate the relationship between RS and lymph node burden.

Methods

Patients with invasive breast cancer who underwent sentinel lymph node dissection from 2010 to 2015 were identified from a prospectively maintained database. Patients were excluded if they were clinically node positive or if they received neoadjuvant chemotherapy. RS was classified as low (< 18), intermediate (18–30), or high (> 30). The association between RS, lymph node burden, and disease recurrence was evaluated. Statistical analyses were performed in R version 3.4.0; p < 0.05 was considered significant.

Results

A positive SLN was found in 168 (15%) of 1121 patients. Completion axillary lymph node dissection was performed in 84 (50%) of SLN-positive patients. The remaining 84 (50%) patients had one to two positive SLNs and did not undergo further axillary surgery. RS was low in 58.5%, intermediate in 32.6%, and high in 8.9%. RS was not associated with a positive SLN, number of positive nodes, maximum node metastasis size, or extranodal extension. The median follow-up was 23 months. High RS was not associated with locoregional recurrence (p = 0.07) but was significantly associated with distant recurrence (p = 0.0015).

Conclusions

OncotypeDX RS is not associated with nodal burden in women with clinically node-negative breast cancer, suggesting that RS is not useful to guide decisions regarding extent of axillary surgery for these patients.

Notes

Disclosure

The authors have no disclosures to report.

Supplementary material

10434_2018_7059_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 12 kb)

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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • S. E. Tevis
    • 1
  • R. Bassett
    • 2
  • I. Bedrosian
    • 3
  • C. H. Barcenas
    • 4
  • D. M. Black
    • 3
  • A. S. Caudle
    • 3
  • S. M. DeSnyder
    • 3
  • E. Fitzsullivan
    • 3
  • K. K. Hunt
    • 3
  • H. M. Kuerer
    • 3
  • A. Lucci
    • 3
  • F. Meric-Bernstam
    • 3
  • E. A. Mittendorf
    • 5
  • K. Park
    • 3
  • M. Teshome
    • 3
  • A. M. Thompson
    • 3
  • R. F. Hwang
    • 3
    Email author
  1. 1.Department of SurgeryUniversity of ColoradoAuroraUSA
  2. 2.Department of Biostatistics, MD Anderson Cancer CenterUniversity of TexasHoustonUSA
  3. 3.Department of Breast Surgical Oncology, MD Anderson Cancer CenterUniversity of TexasHoustonUSA
  4. 4.Department of Breast Medical Oncology, MD Anderson Cancer CenterUniversity of TexasHoustonUSA
  5. 5.Department of SurgeryBrigham and Women’s Hospital, Dana-Farber/Brigham and Women’s Cancer CenterBostonUSA

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