Practical Consequences Resulting from the Analysis of a 21-Multigene Array in the Interdisciplinary Conference of a Breast Cancer Center
During the multidisciplinary planning of postoperative therapy after breast cancer, borderline cases can arise with no clear rationale for or against adjuvant chemotherapy. In 50 hormone- receptor-positive, Her2neu-negative carcinomas of the breast with no or only minimal lymph node involvement (max...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | International Journal of Breast Cancer |
| Online Access: | http://dx.doi.org/10.1155/2018/2047089 |
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| author | Hans-Ullrich Voelker Lea Frey Annette Strehl Michael Weigel |
| author_facet | Hans-Ullrich Voelker Lea Frey Annette Strehl Michael Weigel |
| author_sort | Hans-Ullrich Voelker |
| collection | DOAJ |
| description | During the multidisciplinary planning of postoperative therapy after breast cancer, borderline cases can arise with no clear rationale for or against adjuvant chemotherapy. In 50 hormone- receptor-positive, Her2neu-negative carcinomas of the breast with no or only minimal lymph node involvement (max. pT1a) we initiated an Oncotype DX® multigene assay in addition to the evaluation of usual parameters. In the oncology conference a vote for or against chemotherapy was taken on the basis of the conventional criteria for decision-making before the test results were available. The final recommendation was made after the multigene test. In 32 breast carcinomas (64%) a low recurrence score could be documented, while 26 (32%) showed an intermediate RS and 3 (6%) showed a high RS. In most cases the result of the test could validate the choice of therapy established using conventional criteria. In 5 cases the initial recommendation for adjuvant therapy was revised, and in 3 cases chemotherapy was secondarily recommended after evaluation of the test results. Conversely, in some cases a low or intermediate risk constellation did not argue against a recommendation for adjuvant chemotherapy. Altogether, the results of our study do not indicate that a multigene assay should be used as a routine diagnostic tool. Instead a thorough compilation and careful analysis of conventional parameters for therapeutic decision-making should take precedence, with special emphasis on histopathological and immunohistochemical results. In selected cases, however, a multigene assay can be a useful tool in the deliberation for or against a therapeutic pathway. |
| format | Article |
| id | doaj-art-98430b05be7648b096d2ac66eee1509c |
| institution | Kabale University |
| issn | 2090-3170 2090-3189 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Breast Cancer |
| spelling | doaj-art-98430b05be7648b096d2ac66eee1509c2025-02-03T06:07:07ZengWileyInternational Journal of Breast Cancer2090-31702090-31892018-01-01201810.1155/2018/20470892047089Practical Consequences Resulting from the Analysis of a 21-Multigene Array in the Interdisciplinary Conference of a Breast Cancer CenterHans-Ullrich Voelker0Lea Frey1Annette Strehl2Michael Weigel3Dept. of Pathology, Leopoldina Krankenhaus GmbH, Gustav-Adolf-Str. 8, D-97422 Schweinfurt, GermanyInstitute for Pathology, University of Wuerzburg, Josef-Schneider-Str. 2, D-97080 Wuerzburg, GermanyDept. of Pathology, Leopoldina Krankenhaus GmbH, Gustav-Adolf-Str. 8, D-97422 Schweinfurt, GermanyDept. of Gynecology and Obstetrics, Breast Cancer Centre, Leopoldina Krankenhaus GmbH, Gustav-Adolf-Str. 8, D-97422 Schweinfurt, GermanyDuring the multidisciplinary planning of postoperative therapy after breast cancer, borderline cases can arise with no clear rationale for or against adjuvant chemotherapy. In 50 hormone- receptor-positive, Her2neu-negative carcinomas of the breast with no or only minimal lymph node involvement (max. pT1a) we initiated an Oncotype DX® multigene assay in addition to the evaluation of usual parameters. In the oncology conference a vote for or against chemotherapy was taken on the basis of the conventional criteria for decision-making before the test results were available. The final recommendation was made after the multigene test. In 32 breast carcinomas (64%) a low recurrence score could be documented, while 26 (32%) showed an intermediate RS and 3 (6%) showed a high RS. In most cases the result of the test could validate the choice of therapy established using conventional criteria. In 5 cases the initial recommendation for adjuvant therapy was revised, and in 3 cases chemotherapy was secondarily recommended after evaluation of the test results. Conversely, in some cases a low or intermediate risk constellation did not argue against a recommendation for adjuvant chemotherapy. Altogether, the results of our study do not indicate that a multigene assay should be used as a routine diagnostic tool. Instead a thorough compilation and careful analysis of conventional parameters for therapeutic decision-making should take precedence, with special emphasis on histopathological and immunohistochemical results. In selected cases, however, a multigene assay can be a useful tool in the deliberation for or against a therapeutic pathway.http://dx.doi.org/10.1155/2018/2047089 |
| spellingShingle | Hans-Ullrich Voelker Lea Frey Annette Strehl Michael Weigel Practical Consequences Resulting from the Analysis of a 21-Multigene Array in the Interdisciplinary Conference of a Breast Cancer Center International Journal of Breast Cancer |
| title | Practical Consequences Resulting from the Analysis of a 21-Multigene Array in the Interdisciplinary Conference of a Breast Cancer Center |
| title_full | Practical Consequences Resulting from the Analysis of a 21-Multigene Array in the Interdisciplinary Conference of a Breast Cancer Center |
| title_fullStr | Practical Consequences Resulting from the Analysis of a 21-Multigene Array in the Interdisciplinary Conference of a Breast Cancer Center |
| title_full_unstemmed | Practical Consequences Resulting from the Analysis of a 21-Multigene Array in the Interdisciplinary Conference of a Breast Cancer Center |
| title_short | Practical Consequences Resulting from the Analysis of a 21-Multigene Array in the Interdisciplinary Conference of a Breast Cancer Center |
| title_sort | practical consequences resulting from the analysis of a 21 multigene array in the interdisciplinary conference of a breast cancer center |
| url | http://dx.doi.org/10.1155/2018/2047089 |
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