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. 2021 Mar;124(5):975-981.
doi: 10.1038/s41416-020-01212-w. Epub 2020 Dec 17.

Comprehensive analysis of the 21-gene recurrence score in invasive ductal breast carcinoma with or without ductal carcinoma in situ component

Yufei Zeng #  1 , Weiqi Gao #  1 , Xiaosong Chen  2 , Kunwei Shen  3
Affiliations

Comprehensive analysis of the 21-gene recurrence score in invasive ductal breast carcinoma with or without ductal carcinoma in situ component

Yufei Zeng et al. Br J Cancer. 2021 Mar.

Abstract

Background: Invasive ductal carcinoma (IDC) is often accompanied by ductal carcinoma in situ (DCIS). Whether the DCIS component affects the 21-gene recurrence score (RS) is unclear.

Methods: Consecutive ER-positive, HER2-negative, N0-1 patients with RS results were included. Patients were divided into pure IDC and IDC with DCIS (IDC/DCIS) groups. The RS, the expression of its 16 cancer genes and prognosis were compared between IDC and IDC/DCIS patients.

Results: A total of 1458 patients were enrolled, 320 of whom had concomitant DCIS. DCIS component was independently associated with lower RS (P = 0.038). IDC/DCIS patients more often had a low-risk RS (P = 0.018) or intermediate-risk RS (P = 0.024). Regarding individual genes in the RS panel, Ki67, CCNB1 and MYBL2 in the proliferation group and MMP11 and CTSL2 in the invasion group were significantly lower among IDC/DCIS patients than pure IDC patients. Among IDC/DCIS patients, lower RS was independently correlated with a higher DCIS proportion and lower DCIS grade. Within a median follow-up of 31 months, the DCIS component in IDC did not significantly influence prognosis.

Conclusions: IDC with DCIS component is associated with a lower 21-gene RS, possibly due to lower expression of proliferation and invasion genes. DCIS proportion and grade independently influenced the 21-gene RS in IDC/DCIS patients. Due to the relatively short follow-up period and low recurrence rate, the impact of the DCIS component in IDC on prognosis needs further evaluation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Distribution of the 21-gene RS in breast cancer patients with IDC or IDC/DCIS.
a In all, 21-gene RS as a categorical variable (chi-square test P = 0.002); b 21-gene RS as a continuous variable (Mann–Whitney test P < 0.001).
Fig. 2
Fig. 2. Individual gene expression levels of the 16 cancer genes from the 21-gene RS in breast cancer patients with IDC or IDC/DCIS.
Genes are grouped on the basis of gene function and correlated expression. Proliferation group genes include Ki67, STK15, Survivn, CCNB1, and MYBL2. Invasion group genes include MMP11 and CTSL2. HER2 group genes include GRB7 and HER2. ER Proliferation group genes include ER, PR, BCL2, and SCUBE2. Significant P-value (<0.05) are in bold.
Fig. 3
Fig. 3. Distribution of 21-gene RS among IDC/DCIS patients.
a In all, 21-gene RS as a categorical variable in patients with different DCIS grades (chi-square test P < 0.001); b 21-gene RS as a continuous variable in patients with different DCIS grades (Kruskal–Wallis test P < 0.001); c 21-gene RS as a categorical variable in patients with different proportions of DCIS (chi-square test P = 0.057); d 21-gene RS as a continuous variable in patients with different proportions of DCIS (Mann–Whitney test P = 0.064).
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References

    1. Kuerer HM, Albarracin CT, Yang WT, Cardiff RD, Brewster AM, Symmans WF, et al. Ductal carcinoma in situ: state of the science and roadmap to advance the field. J. Clin. Oncol. 2009;27:279–288. doi: 10.1200/JCO.2008.18.3103. - DOI - PubMed
    1. Espina V, Liotta LA. What is the malignant nature of human ductal carcinoma in situ? Nat. Rev. Cancer. 2011;11:68–75. doi: 10.1038/nrc2950. - DOI - PMC - PubMed
    1. Holland R, Connolly JL, Gelman R, Mravunac M, Hendriks JH, Verbeek AL, et al. The presence of an extensive intraductal component following a limited excision correlates with prominent residual disease in the remainder of the breast. J. Clin. Oncol. 1990;8:113–118. doi: 10.1200/JCO.1990.8.1.113. - DOI - PubMed
    1. Chagpar AB, McMasters KM, Sahoo S, Edwards MJ. Does ductal carcinoma in situ accompanying invasive carcinoma affect prognosis? Surgery. 2009;146:561–567. doi: 10.1016/j.surg.2009.06.039. - DOI - PubMed
    1. Logullo AF, Godoy AB, Mourao-Neto M, Simpson AJ, Nishimoto IN, Brentani MM. Presence of ductal carcinoma in situ confers an improved prognosis for patients with T1N0M0 invasive breast carcinoma. Braz. J. Med. Biol. Res. = Rev. brasileira de. Pesqui. medicas e biologicas. 2002;35:913–919. doi: 10.1590/S0100-879X2002000800008. - DOI - PubMed

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