Abstract:

 Objective To analyses the utility of 21-gene recurrence score assay in treatment decisions for women with hormonal-receptor positive （HR+） and HER2-early breast cancer （EBC）. Methods A total of 29 female patients with HR + EBC who had been hospitalized in Jiangmen Central Hospital, from January 2016 to January 2017, were divided into low risk group and intermediate/high risk group according to the recurrence score. The general clinical pathological characteristics and the treatment recommendations before and after 21-gene recurrence score assay in each groups were compared. Results Association analysis showed that recurrence score was no relative with ages, menopausal status, tumor size, histopathological grade and vascular invasion, but significantly associative with Ki-67（P=0.027）. About 18 patients （62.0%） recommended endocrine therapy combined with adjuvant chemotherapy before 21-gene recurrence score assay. The proportion of patients recommended chemotherapy decreased from 62.0% pretest to 24.1% post?test（McNemar’s test, P=0.001）. 11 patients （37.9%）changed treatment decisions to endocrine therapy alone. Conclusion Using 21?gene recurrence score assay can significantly change treatment decisions and make an overall reduction in chemotherapy use in women with hormonal?receptor positive early breast cancer.

Key words: early breast cancer, 21?gene, recurrence score, hormonal?receptor positive, treatment decisions

摘要：

目的 初步分析21基因检测复发风险评分（recurrencescore®，RS）对激素受体阳性早期乳腺癌的治疗决策导向作用。方法 2016年1月至2017年1月于江门市中心医院普通外科住院并行手术治疗的激素受体阳性早期乳腺癌患者29例，按照21基因检测复发风险评分结果分成低危组与中/高危组，比较其临床病理特征及评分前后的治疗决策。结果 在患者的临床特征与RS复发分数的关联性分析中提示，复发风险分组与年龄、绝经状态、肿瘤直径、病理组织学分级及脉管癌栓等均无明显相关，而与Ki?67的表达（P=0.027）有关。在行21基因检测前，共有18例（62.0%）患者推荐内分泌治疗联合辅助化疗；公布RS复发分数后，11例（37.9%）患者被推荐改变为单纯内分泌治疗，7例（24.1%）患者仍建议行辅助化疗（McNemar’stest，P=0.001）。结论  对于激素受体阳性早期乳腺癌患者，增加21基因检测并计算复发风险评分能显著改变治疗决策，降低不必要的辅助化疗的比例。

关键词: 早期乳腺癌, 21 基因, 复发风险评分, 激素受体阳性, 治疗决策