Relevance of progesterone receptor immunohistochemical staining to Oncotype DX recurrence score. Hematol Oncol Stem Cell Ther 2016 Jun;9(2):48-54
Date
01/26/2016Pubmed ID
26808222DOI
10.1016/j.hemonc.2015.12.001Scopus ID
2-s2.0-84955577378 (requires institutional sign-in at Scopus site) 35 CitationsAbstract
OBJECTIVE/BACKGROUND: Progesterone-receptor negativity (PR-) is predictive of adverse outcomes in estrogen receptor-positive (ER+) breast cancer. The Oncotype DX assay provides risk stratification for hormone receptor-positive (HR+) invasive breast cancer; however, the association of PR status and Oncotype DX recurrence scores (RSs) is less clear.
METHODS: We designed an analysis to determine whether a significant difference exists in the RS for ER+/PR- tumors when compared with ER+/PR+ breast cancer. Three hundred and fifty patients with HR+ invasive breast cancer who underwent Oncotype DX testing at our institution from December 2006 to October 2013 were included. We also examined the concordance in the HR status reported by immunohistochemical (IHC) and reverse transcriptase-polymerase chain reaction (RT-PCR) analyses. The data were analyzed by analysis of variance, F test, t test, and chi-square tests. Multivariate linear regression was used to determine significant predictors of Oncotype DX RS.
RESULTS: A total of 301 patients had ER+/PR+ tumors and 47 patients had ER+/PR- tumors by IHC. PR- tumors had a significantly higher RS than PR+ tumors (24.7±8.53 vs. 17.3±7.38; p<.001), predicting a greater 10-year risk of distant recurrence. Multivariate linear regression showed PR status and tumor grade to be significant predictors of Oncotype DX RS (p<.0001). A total of 284 patients had HR status reported by Oncotype DX assay. Concordance between IHC and RT-PCR was 99.3% for ER and 88.7% for PR.
CONCLUSION: Our study shows that ER+/PR- breast cancer tumors are associated with a significantly higher Oncotype DX scores; this interprets into a higher risk of recurrence. Our data also show that the concordance between IHC and RT-PCR was 99.3% for ER and lower at 88.7% for PR.
Author List
Chaudhary LN, Jawa Z, Szabo A, Visotcky A, Chitambar CRAuthors
Lubna N. Chaudhary MD Associate Professor in the Medicine department at Medical College of WisconsinAniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Alexis M. Visotcky Biostatistician III in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
FemaleHumans
Immunohistochemistry
Linear Models
Middle Aged
Multivariate Analysis
Neoplasm Grading
Neoplasm Recurrence, Local
Real-Time Polymerase Chain Reaction
Receptors, Progesterone
Staining and Labeling
