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. 2013 Sep;24(9):2292-7.
doi: 10.1093/annonc/mdt183. Epub 2013 May 24.

A simple and reproducible prognostic index in luminal ER-positive breast cancers

I Castellano  1 , L Chiusa, A M Vandone, S Beatrice, M Goia, M Donadio, R Arisio, F Muscarà, A Durando, G Viale, P Cassoni, A Sapino
Affiliations

A simple and reproducible prognostic index in luminal ER-positive breast cancers

I Castellano et al. Ann Oncol. 2013 Sep.

Abstract

Background: The group of estrogen receptor (ER)-positive breast cancers (both luminal-A and -B) behaves differently from the ER-negative group. At least in early follow-up, ER expression influences positively patients' prognosis. This low aggressive biology flattens out the differences of clinical management. Thus we aimed to produce a prognostic index specific for ER-positive (ERPI) cancers that could be of aid for clinical decision.

Patients and methods: The test set comprised 495 consecutive ER-positive breast cancers. Tumor size, number of metastatic lymph nodes and androgen receptor expression were the only independent variables related to disease-specific survival. These variables were used to create the ERPI, which was applied to the entire test set and to selected subpopulations (grade 2 (G2)-tumors, luminal-A and -B breast cancers). A series of 581 ER-positive breast cancers, collected from another hospital, was used to validate ERPI.

Results: In the test population, 96.9% of patients classified as ERPI-good showed a good prognosis compared with 79.6% classified as ERPI-poor (P < 0.001). ERPI effectively discriminated outcome in luminal-A and luminal-B and in G2-tumors. In the validation series, the ERPI maintained its value.

Conclusion: ERPI is a practical tool in refining the prediction of outcome of patients with ER-positive breast cancer.

Keywords: AR expression; ER expression; breast cancer; lymph nodal status; prognostic index; tumor size.

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Figures

Figure 1.
Figure 1.
Kaplan–Meier analysis carried out on test cohort for each ERPI value (A). Kaplan–Meier analysis carried out for ERPI value using a cut-off of 3: a value ≤3 was considered as ERPI-good and a value >3 as ERPI-poor (B). ERPI on G2 (C), luminal-A (D) luminal-B and luminal-B HER2-negative cases (E, F).
Figure 2.
Figure 2.
Kaplan–Meier analysis carried out on validation cohort for each ERPI value (A). Kaplan–Meier analysis carried out for ERPI value using a cut-off of 3: a value ≤3 was considered as ERPI-good and a value >3 ERPI-poor (B). ERPI on G2 (C), luminal-A (D) luminal-B and luminal-B HER2 negative cases (E, F).
See this image and copyright information in PMC

References

    1. Perou CM, Sørlie T, Eisen MB, et al. Molecular portraits of human breast tumours. Nature. 2000;406:747–752. - PubMed
    1. Varga Z, Diebold J, Dommann-Scherrer C, et al. How reliable is Ki-67 immunohistochemistry in grade 2 breast carcinomas? A QA Study of the Swiss Working Group of Breast- and Gynecopathologists. PLoSOne. 2012;7:e37379. - PMC - PubMed
    1. Longacre TA, Ennis M, Quenneville LA, et al. Interobserver agreement and reproducibility in classification of invasive breast carcinoma: an NCI breast cancer family registry study. Mod Pathol. 2006;19:195–207. - PubMed
    1. Dalton LW, Page DL, Dupont WD. Histologic grading of breast carcinoma. A reproducibility study. Cancer. 1994;73:2765–2770. - PubMed
    1. Tsuda H, Kurosumi M, Umemura S, et al. HER2 testing on core needle biopsy specimens from primary breast cancers: interobserver reproducibility and concordance with surgically resected specimens. BMC Cancer. 2010;10:534. - PMC - PubMed

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