Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

For: Fayaz S, Eissa HES, Demian GA. Implications of the 21-gene recurrence score assay (Oncotype DX) on adjuvant treatment decisions in ER-positive early-stage breast cancer patients: experience of Kuwait Cancer Control Center. J Egypt Natl Canc Inst 2020;32:13. [PMID: 32372329 DOI: 10.1186/s43046-020-00025-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 02/13/2020] [Indexed: 01/09/2023] Open

Number

Cited by Other Article(s)

Al-Shamsi HO, Abdelwahed N, Abyad A, Abu-Gheida I, Afrit M, Abu ElFuol T, Alasas R, Lababidi B, Dash P, Ahmad M, Dreier NW, ul Haq U, Joshua TLA, Otsmane S, Al-Nouri A, Al-Awadhi A, Tirmazy SH, Alterkait F, Elsabae S, Khan N, Albastaki NK, Sonawane Y, Jouda M, Perdawood F, Iqbal F, Jaafar H. Breast Cancer in the Arabian Gulf Countries. Cancers (Basel) 2023;15:5398. [PMID: 38001658 PMCID: PMC10670541 DOI: 10.3390/cancers15225398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open

Abstract

Breast cancer stands as the prevailing malignancy across all six Gulf Cooperation Council (GCC) nations. In this literature review, we highlighted the incidence and trend of breast cancer in the GCC. Most of the studies reported a consistent increase in breast cancer incidence over the past decades, which was particularly attributed to the adoption of a Westernized lifestyle in the region and the implications of emerging risk factors and other environmental and societal factors, the increase in screening uptake, as well as the improvement in data collection and reporting in the GCC. The data on breast cancer risk factors in the GCC were limited. In this geographic region, breast cancer frequently manifests with distinctive characteristics, including an early onset, typically occurring before the age of 50; an advanced stage at presentation; and a higher pathological grade. Additionally, it often exhibits more aggressive features such as human epidermal growth factor receptor 2 (HER2) positivity or the presence of triple-negative (TN) attributes, particularly among younger patients. Despite the growing body of literature on breast cancer in the GCC, data pertaining to survival rates are, regrettably, meager. Reports on breast cancer survival rates emanating from the GCC region are largely confined to Saudi Arabia and the United Arab Emirates (UAE). In the UAE, predictive modeling reveals 2-year and 5-year survival rates of 97% and 89%, respectively, for the same period under scrutiny. These rates, when compared to Western counterparts such as Australia (89.5%) and Canada (88.2%), fall within the expected range. Conversely, Saudi Arabia reports a notably lower 5-year survival rate, standing at 72%. This disparity in survival rates underscores the need for further research directed toward elucidating risk factors and barriers that hinder early detection and screening. Additionally, there is a pressing need for expanded data reporting on survival outcomes within the GCC. In sum, a more comprehensive and nuanced understanding of breast cancer dynamics in this region is imperative to inform effective strategies for prevention, early detection, and improved patient outcomes.

Collapse

Affiliation(s)

Humaid O. Al-Shamsi Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates; Department of Clinical Sciences, College of Medicine, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
Nadia Abdelwahed Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Amin Abyad Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Ibrahim Abu-Gheida Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Mehdi Afrit Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Tasneem Abu ElFuol Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
Ryad Alasas Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Bilal Lababidi Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Prasanta Dash Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Mudhasir Ahmad Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Norbert W. Dreier Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Urfan ul Haq Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Thanda Lucy Ann Joshua Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Sonia Otsmane Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Anwar Al-Nouri Kuwait Cancer Control Center, Kuwait City, Kuwait; (A.A.-N.); (F.A.)
Aydah Al-Awadhi Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Syed Hammad Tirmazy Dubai Hospital, Dubai P.O. Box 7272, United Arab Emirates;
Faisal Alterkait Kuwait Cancer Control Center, Kuwait City, Kuwait; (A.A.-N.); (F.A.)
Shimaa Elsabae Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
Nyla Khan Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
Nehad Kazim Albastaki Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
Yoginee Sonawane Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;
Mohammed Jouda Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
Frea Perdawood Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
Faryal Iqbal Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.)
Hassan Jaafar Burjeel Medical City, Abu Dhabi P.O. Box 92510, United Arab Emirates; (N.A.); (A.A.); (I.A.-G.); (M.A.); (T.A.E.); (R.A.); (B.L.); (P.D.); (M.A.); (N.W.D.); (U.u.H.); (T.L.A.J.); (S.O.); (S.E.); (N.K.); (N.K.A.); (Y.S.); (M.J.); (F.P.); (F.I.); (H.J.) Emirates Oncology Society, Dubai P.O. Box 6600, United Arab Emirates;

Collapse

Saad Abdalla Al-Zawi A, Yin SL, Mahmood B, Jalil A, Aladili Z. The Oncotype DX Recurrence Score's Impact on the Management of Oestrogen-Positive/Human Epidermal Growth Factor Receptor 2-Negative, Low-Burden Axillary Status Breast Cancer (REHAB Study): Results of a Single Centre. Cureus 2022;14:e27341. [PMID: 36042999 PMCID: PMC9411820 DOI: 10.7759/cureus.27341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/25/2022] Open

Abstract

Background

The Oncotype DX Recurrence Score (ODX-RS) is increasingly utilized in oestrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, low-burden axillary disease early operable breast cancer. It has been demonstrated to predict the benefits of adjuvant chemotherapy, hence supporting individualized decisions on adjuvant therapy.

Aim

To investigate the application of ODX-RS as an adjuvant treatment decision tool in breast cancer operated in our unit.

Methods

A total of 107 eligible patients who were operated on between 2017 and 2021 in Basildon University Hospital, UK were enrolled in this study. In this retrospective study, the clinical data, including patient’s age, tumour size, ER status, HER2 status, Ki67 proliferative index (Ki67-PI), nodal status, tumour grade, and ODX-RS, were collected. In the study design, the oncologist had the opportunity to assess the need for adjuvant chemotherapy for patients with ER-positive, HER2-negative, low-burden axillary lymph node disease, early breast cancer by using tumour characteristics and the PREDICT tool without knowing the ODX-RS results. The clinician's decision was matched against the breast multidisciplinary team's recommendations after ODX-RS utilisation, and the results were explored.

Results

The median ODX-RS of cohort tumours was 18 in the age group > 50 years, with ODX-RS ≥ 26 found in 18% of the group (n = 12). In the age group ≤ 50 years, 17% (n = 7) had ODX-RS between 21 and 25 and only 7% (n = 3) had ODX-RS ≥ 26. Without using ODX-RS, only 16% of the patients had been offered adjuvant chemotherapy in addition to the hormonal manipulation therapy; however, after using ODX-RS, up to 33% of the cohort was suitable for adjuvant chemotherapy in addition to the hormonal manipulation therapy. The changes in the recommendations after ODX-RS utilisation have been noticed in 29% of the cohort.

Conclusion

This study revealed that ODX-RS supported decision-making regarding postoperative adjuvant chemotherapy, especially when other tumour biomarkers, such as tumour size, grading, or Ki-67, indicated lower risk criteria. Patients with a high ODX-RS were offered chemotherapy where appropriate and its use led to a 15% rate of initial decision change in adjuvant treatment decisions; this involved either recommending chemotherapy or its omission.

Collapse

Parikh PM, Bhattacharyya GS, Biswas G, Krishnamurty A, Doval D, Heroor A, Sharma S, Deshpande R, Chaturvedi H, Somashekhar SP, Babu G, Reddy GK, Sarkar D, Desai C, Malhotra H, Rohagi N, Bapna A, Alurkar SS, Krishna P, Deo SV, Shrivastava A, Chitalkar P, Majumdar SK, Vijay D, Thoke A, Udupa KS, Bajpai J, Rath GK, Dattatreya PS, Bondarde S, Patil S. Practical Consensus Recommendations for Optimizing Risk versus Benefit of Chemotherapy in Patients with HR Positive Her2 Negative Early Breast Cancer in India. South Asian J Cancer 2021;10:213-219. [PMID: 34984198 PMCID: PMC8719963 DOI: 10.1055/s-0041-1742080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open

Affiliation(s)

Purvish M. Parikh Mumbai Oncocare Centers, Mumbai, India
Gouri Shankar Bhattacharyya Fortis Hospital, Anandapur, Kolkata, West Bengal, India
Ghanshyam Biswas Medical Oncology, Sparsh Hospital & Critical Care, Bhubaneswar, India
Arvind Krishnamurty Surgical Oncology, Cancer Institute (Adyar), Chennai, India
Dinesh Doval Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
Anil Heroor Surgical Oncology, Fortis Hospital, Mumbai, India
Sanjay Sharma Surgical Oncology, Asian Cancer Institute, Mumbai, India
Ramakant Deshpande Surgical Oncology, Asian Cancer Institute, Mumbai, India
Harit Chaturvedi Surgical Oncology, Max Institute of Cancer Care, Delhi, India
S. P. Somashekhar Surgical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospital, Bangalore, India
Govind Babu Medical Oncology, HCG Cancer Hospital, Bengaluru, India
G. Krishna Reddy Medical Oncology, Manipal Hospitals, Vijaywada, India
Diptendra Sarkar Surgical Oncology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
Chirag Desai Medical Oncology, Vedanta Institute of Medical Sciences, Ahmedabad, India
Hemant Malhotra Medical Oncology, MG Hospital, Jaipur, India
Nitesh Rohagi Medical Oncology, Max Institute of Cancer Care, Delhi, India
Ajay Bapna Medical Oncology, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, India
S. S. Alurkar Medical Oncology, Apollo Hospital, Ahmedabad, India
Prasad Krishna Medical Oncology, Mangalore Institute of Oncology, Mangalore, India
S. V.S. Deo Surgical Oncology, All India Institute of Medical Sciences, Delhi, India
Anurag Shrivastava Surgery, All India Institute of Medical Sciences, Delhi, India
Prakash Chitalkar Medical Oncology, Sri Aurobindo Medical College and Postgraduate Institute, Indore, India
Saroj Kumar Majumdar Radiation Oncology, AIIMS, Bhubaneswar, India
Devanhalli Vijay Surgical Oncology, HCG Cancer Hospital, Ahmedabad, India
Aniket Thoke Radiation Oncology, Sanjeevani CBCC USA Cancer Hospital, Raipur, India
K. S. Udupa Medical Oncology, Kasturba Medical College, Manipal, India
Jyoti Bajpai Medical Oncology, Tata Memorial Hospital, Mumbai, India
G. K. Rath Radiation Oncology, DR. B.R.A. Institute Rotary Cancer Hospital, Delhi, India
Palanki Satya Dattatreya Medical Oncology, Omega Hospitals, Hyderabad, India
Shailesh Bondarde Medical Oncology, Shatabdi Super Speciality Hospital, Nashik, India
Shekhar Patil Medical Oncology, HCG Cancer Hospital, Bengaluru, India

Collapse

Alkushi A, Omair A, Masuadi E, Alamri G, Abusanad A, Abdelhafiez N, Mohamed AE, Abulkhair O. The Level of Agreement Among Medical Oncologists on Adjuvant Chemotherapy Decision for Breast Cancer in Pre and Post-Oncotype DX Settings. Cureus 2021;13:e13298. [PMID: 33738150 PMCID: PMC7958828 DOI: 10.7759/cureus.13298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open

Abstract

INTRODUCTION

The Oncotype DX assay plays an important role in the identification of the specific subset of hormone receptor (HR)-positive and node-negative breast cancer (BC) patients, who would benefit the most from adjuvant chemotherapy. The current study aimed at assessing the level of agreement among medical oncologists on adjuvant chemotherapy decisions before and after Oncotype DX, as well as the intra-observer agreement of each medical oncologist's decision of prescribing adjuvant chemotherapy based on clinicopathological and immunohistochemical parameters only and followed by Oncotype DX recurrence score (RS) results.

METHODS

A retrospective analysis of data related to clinicopathological and immunohistochemical parameters, and Oncotype DX RS result for 145 female, estrogen receptor (ER)-positive, HER2 negative, and both node-negative and positive BC patients was performed. Initially, the data without Oncotype DX RS was sent to 16 oncologists in multiple centers in the Middle East. After one week, the same data with the shuffling of cases were sent to the oncologists with the addition of the Oncotype DX RS result for each patient. The inter and intra-observer agreement (kappa and Fleiss multi-rater kappa) among oncologists' decision of prescribing adjuvant chemotherapy pre and post-Oncotype DX RS results were assessed. Oncotype DX risk scores were used as continuous variables as well as based on old RS grouping, categorized into low (0-17), intermediate (18-30), and high risk (≥ 31) groups. A test with a p-value of < 0 .05 will be considered statistically significant.

RESULTS

The mean age ± SD of the cohort was 51.9 ± 9.4 years. Sixty-nine patients (47.6%) were premenopausal whereas 76 patients (52.4%) were postmenopausal. The mean Oncotype DX RS was 17.8 ± 8.6 and 54.5% had low recurrence risk (RR), 37.9% had intermediate RR and only 7.6% had high RR. The majority of our cases were grade two (53.1%) and T stage one (49%), whereas 29.7% had positive one to three lymph nodes. The addition of Oncotype DX results improved the agreement among oncologists' decision from fair to moderate (kappa = 0.52; p <0.001). On average, an oncologist's decision of prescribing adjuvant chemotherapy pre and post-Oncotype DX had an agreement in 70.6% of the cases, with agreement observed mostly for cases where the initial decision of adjuvant chemotherapy was (no) and it was retained with post-Oncotype DX assay (46.1%), compared to 24.5% cases where the initial decision was (yes) and it was retained with post-Oncotype DX assay (kappa = 0.39; p <0.001). The addition of the Oncotype DX RS result avoided chemotherapy in 20.4% of cases and identified 9% of cases as candidates for adjuvant chemotherapy (kappa = 0.38; p <0.001). The disagreement was highest among cases with intermediate RR (33.6%) followed by high and low RR (31.3% and 21.6%) with a statistical significance of <0.001.

CONCLUSION

We conclude that the Oncotype DX RS significantly influenced the decision to prescribe adjuvant chemotherapy among HR-positive, HER2 negative, and both node-negative and positive patients, as it increased the level of agreement among oncologists and led to a decrease in the use of adjuvant chemotherapy compared to the pre-Oncotype recommendations.

Collapse