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Meta-Analysis
. 2022 Aug:64:41-46.
doi: 10.1016/j.breast.2022.04.009. Epub 2022 Apr 28.

Relevance of the 21-gene expression assay in male breast cancer: A systematic review and meta-analysis

Matthew G Davey  1 , Ciara M Davey  2 , Luis Bouz  2 , Eoin Kerin  2 , Carson McFeetors  2 , Aoife J Lowery  2 , Michael J Kerin  2
Affiliations
Meta-Analysis

Relevance of the 21-gene expression assay in male breast cancer: A systematic review and meta-analysis

Matthew G Davey et al. Breast. 2022 Aug.

Abstract

Introduction: The 21-gene assay provides prognostication for estrogen receptor positive, human epidermal growth factor receptor-2 negative (ER+/HER2-) early female breast cancer patients. This signature has not been validated in male breast cancer (MBC).

Methods: A systematic review and meta-analysis was performed in accordance to the PRISMA guidelines. Retrospective cohort studies comparing 21-gene assay scores in female and MBC were included. Dichotomous variables were pooled as odds ratios (OR) and associated 95% confidence intervals (CI) using the Mantel-Haenszel method.

Results: Six studies including 176,338 patients were included (mean age of 63.4 years, range: 33-88). Of these, 1.0% had MBC (1826/176,338) and 99.0% were female patients (174,512/176,338). MBC patients were more likely to have increased tumour stage, nodal involvement, and grade 3 disease (all P < 0.001) In MBC patients, the mean score was 18.8 (range: 11-26) vs. 13.4 (range 0-33) in female patients (P < 0.001). In MBC patients, 22.4% had scores >30 (408/1822) versus 18.3% in female patients (31,852/174,500). In female patients, 52.0% had scores <18 (90,787/174,500) versus 47.8% in MBC (471/1822). Overall, patients with female patients were as likely to have scores <18 (OR: 1.04, 95% CI: 0.94-1.16), scores 18-30 (OR: 1.12, 95% CI: 1.00-1.26) and scores >30 (OR: 0.69, 95% CI: 0.45-1.07) as MBC patients.

Conclusion: There are similar anticipated scores for female and MBC undergoing 21-gene expression assay testing for early stage, ER+/HER2-breast cancer. In the absence of stage matching, cautious interpretation of these results is required. Validation of the 21-gene assay in MBC is still required.

Keywords: Cancer genomics; Male breast cancer; Personalised medicine; Precision oncology.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram detailing the systematic search process.
Fig. 2
Fig. 2
Forest plots illustrating male breast cancer patients were more equally as likely to have a 21-gene expression assay score less than 18 (A), a score of 18–30 (B), and a score >30 (C).
See this image and copyright information in PMC

References

    1. Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30. - PubMed
    1. Fentiman I. Male breast cancer: a review. Ecancermedicalscience. 2009;3:140. - PMC - PubMed
    1. Fentiman I.S., Fourquet A., Hortobagyi G.N. Male breast cancer. Lancet. 2006;367(9510):595–604. - PubMed
    1. Korde L.A., Zujewski J.A., Kamin L., Giordano S., Domchek S., Anderson W.F., et al. Multidisciplinary meeting on male breast cancer: summary and research recommendations. J Clin Oncol. 2010;28(12):2114–2122. - PMC - PubMed
    1. Li X., Yang J., Krishnamurti U., Huo L., Ward K.C., O'Regan R., et al. Hormone receptor-positive breast cancer has a worse prognosis in male than in female patients. Clin Breast Cancer. 2017;17(5):356–366. - PubMed

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