Related Experiment Video
Updated: Sep 10, 2025
High-Throughput Dissociation and Orthotopic Implantation of Breast Cancer Patient-Derived Xenografts
Published on: December 20, 2024
Biology is Queen: The Oncotype DX 21-Gene Recurrence Score Has Stronger Prognostic Ability than Lymph Node Burden for
Chelsea Marin1, Myla Strawderman2, Derick Peterson2
1Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.
Background:
Breast cancer treatment is increasingly based on biologic instead of anatomic factors; however, some decisions still rely on anatomic information obtained at axillary lymph node dissection (ALND), such as chemotherapy administration. The goal of this study was to determine if the Oncotype DX 21-gene recurrence score (RS) or the number of positive lymph nodes (+LNs) were stronger predictors of overall survival (OS), to potentially support ALND omission.
Methods:
The National Cancer Database was queried for patients aged ≥18 years with non-metastatic, hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) breast cancer with available RS treated with upfront surgery from 2018 to 2019. We summarized clinical characteristics, estimated OS via Kaplan-Meier curves, and performed regression analyses to determine the association of RS and +LNs with OS.
Results:
Among 71,235 patients analyzed, OS was significantly worse for patients with RS >25 compared with ≤25 (p<0.0001) and for patients with increasing numbers of +LNs (p < 0.0001). Within most LN categories (0, 1-3, 4-9, or ≥10 +LNs), patients with RS >25 had worse OS than patients with RS ≤25 (p < 0.0001, p < 0.0001, p = 0.0024, and p = 0.1767, respectively). On regression analysis, RS >25 and +LNs significantly predicted OS. RS >25 was a stronger predictor of OS than number of +LNs, but the model combining RS and number of +LNs was stronger than either factor alone.
Conclusions:
This study of patients with HR+/HER2- breast cancer suggests RS is a stronger predictor of death compared with LN status. This supports the idea that biologic factors may be more impactful than anatomic factors but does not currently obviate the need for ALND.
More Related Videos
07:13Comparison of Predictive Performance of Three Lymph Node Staging Systems in Colorectal Signet Ring Cell Carcinoma Based on Machine Learning Model
Published on: April 18, 2025
10:27Testing Targeted Therapies in Cancer using Structural DNA Alteration Analysis and Patient-Derived Xenografts
Published on: July 25, 2020
Related Concept Videos
01:21Cancer Survival Analysis
01:33Cancer-Critical Genes I: Proto-oncogenes
When the function of certain critical genes, especially those involved in cell cycle regulation and cell growth signaling cascades, gets disrupted, it upsets the cell cycle progression. Such cells with unchecked cell cycles start proliferating uncontrollably and eventually develop into tumors.
Such genes that act...
01:20The Retinoblastoma Gene
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
02:07Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...