Clinical Topics   /   Oncology

Risk Predictor Guides Breast Cancer Treatment at MHS Facility

by Annette Boyle
June 1, 2018

SAN ANTONIO, TX — Physicians and patients want to do everything possible to minimize the risk of breast cancer recurrence without incurring unnecessary toxicity from chemotherapy. While staging and subtype provide significant indications of risk, some women will progress despite apparently good indicators.

To help optimize decision-making, the MHS relies on a recurrence score to select patients for chemotherapy. The results have been excellent, reported a study released in conjunction with the 2018 American Society of Clinical Oncology Annual Meeting this weekend in Chicago.1

Researchers at the San Antonio Military Medical Center at Fort Sam Houston, TX, described use of an Oncotype DX database over a 10-year span at their facility. The retrospective cohort study analyzed results from 149 patients treated between 2007 and 2017. All but one patient had hormone-positive, node-negative breast cancer, a profile associated with generally good outcomes.

The Oncotype DX breast cancer assay uses 21 genes to analyze tumors to determine risk of recurrence. Scores below 18 predict a low risk of recurrence and indicate that hormone therapy alone will likely suffice. Scores above 30 are associated with higher risk that could be minimized with adjuvant chemotherapy.

The San Antonio cohort included 70 (47%) categorized as low risk, 60 women (41%) considered intermediate risk and 18 patients (12%) classified as high risk. Patients who had hormone negative or HER2 positive tumors were considered high risk.

Researchers found no correlation between patient age, ethnicity or score severity and risk classification. Higher histological grades, larger tumors and higher recurrence rates corresponded to higher risk scores.

Physicians’ recommendations for therapy generally followed the treatment suggested as appropriate by the recurrence score. Chemotherapy was offered to just 7% of the women with low-risk scores. In contrast, 52% of the intermediate-risk women received chemotherapy, as did 100% of those considered high risk.

Five-year progression free survival in this cohort supported the initial risk assessment, at 98.6% for low-risk women and 93.3% for women with intermediate risk. Among high-risk women, five-year progression free survival was 88.2%.


1Wan W, Aden J, Terrazzino S, Villarreal S, Delacruz WP. Application of a 21-gene recurrence score assay in node negative, hormone receptor positive breast cancer in a military treatment facility. 2018 ASCO Annual Meeting. Abstract e12567.

Related Articles

Hypertension, MGUS Associated with Herbicide Exposure in Vietnam Veterans

Based on a new review, two conditions–one extremely common and the other rare–appear to be related to herbicide exposure during the Vietnam War era.

Detailed Medical History Crucial for Lung Disease Diagnosis

Both general medicine physicians and specialists can find interstitial lung disease (ILD) and pulmonary fibrosis confusing, according to a recent study.


U.S. Medicine Recommends


More From oncology

Oncology

Hypertension, MGUS Associated with Herbicide Exposure in Vietnam Veterans

Based on a new review, two conditions–one extremely common and the other rare–appear to be related to herbicide exposure during the Vietnam War era.

Oncology

Detailed Medical History Crucial for Lung Disease Diagnosis

Both general medicine physicians and specialists can find interstitial lung disease (ILD) and pulmonary fibrosis confusing, according to a recent study.

Oncology

Melanomas Associated With Internal Malignancy Risk

Genetic and environmental risk factors have been associated with the development of multiple primary melanomas (MPM) but a new study questioned whether those patients might have increased predisposition to developing internal malignancies.

Oncology

Some RCC Risk Factors Can Be Modified

Obesity, hypertension and smoking are the three modifiable risk factors that could aggressively be targeted to reduce renal cell carcinoma, according to a new study.

Oncology

Better Survival for NSCLC Patients Treated by Military Medicine

Does universal healthcare access provided by the MHS translate into improved patient outcomes for non-small cell lung cancer?

[wpdevart_facebook_comment curent_url=" http://www.usmedicine.com/clinical-topics/oncology/risk-predictor-guides-breast-cancer-treatment-at-mhs-facility/ " order_type="social" title_text="Facebook Comment" title_text_color="#000000" title_text_font_size="22" title_text_font_famely="monospace" title_text_position="left" width="100%" bg_color="#d4d4d4" animation_effect="random" count_of_comments="3" ]

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up