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Axillary nodal disease burden is not associated with an elevated 21-gene recurrence score in post-menopausal women presenting with a clinically negative axilla.

Publication ,  Journal Article
Botty van den Bruele, A; Paul, MA; Thomas, SM; Sammons, SL; DiNome, ML; Plichta, JK; Record, SM; Woriax, H; Chiba, A; Rosenberger, LH; Hwang, ES
Published in: Am J Surg
July 2024

BACKGROUND: The predictive and prognostic value of the recurrence score (RS) has emphasized the importance of tumor biology and has reduced the prognostic implications of limited nodal burden in post-menopausal women with HR+/HER2-invasive breast cancer (IBC). It is unclear whether routine axillary staging has a continued role in the management of small, clinically node negative (cN0) HR+/HER2- IBC. We sought to estimate the association of RS with pN stage. METHODS: Patients >50yo diagnosed with cN0, HR+/HER2- IBC (2015-2019) with an available RS were identified from the National Cancer Database. The clinicopathologic characteristics and rates of pN-stage (pN0, pN1, pN2/3) were compared for RS of ≤25 vs. >25. RESULTS: The median patient age was 64.1 (IQR 58-69) and the majority (75%) of tumors displayed ductal histology. Most (81.6%) were cT1 on presentation and pT1 (74.7%) on final pathology. There were 130,568 (86.2%) with a RS ​≤ ​25 and 20,879 (13.8%) with a RS ​> ​25. On final pathology, 128,995 (85.2%) were pN0 and 21,991 (14.5%) pN1. Of the pN1, 2699 (12.3%) yielded a RS ​> ​25. There were 461 (0.3%) patients with pN2-pN3 disease. Of those, 57 (12.4%) had RS ​> ​25. CONCLUSION: In our analysis, pN0 and pN1 tumors are biologically similar by gene expression assay in postmenopausal patients with similar proportions of high RS. These data support the notion that tumor biology examined via RS may have more prognostic and predictive value than metastatic dissemination to limited lymph nodes. These findings support the ongoing evaluation of routine axillary staging in postmenopausal patients with HR+/HER2- IBC.

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Published In

Am J Surg

DOI

EISSN

1879-1883

Publication Date

July 2024

Volume

233

Start / End Page

45 / 51

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Prognosis
  • Postmenopause
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Lymphatic Metastasis
  • Lymph Nodes
  • Humans
 

Citation

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Botty van den Bruele, A., Paul, M. A., Thomas, S. M., Sammons, S. L., DiNome, M. L., Plichta, J. K., … Hwang, E. S. (2024). Axillary nodal disease burden is not associated with an elevated 21-gene recurrence score in post-menopausal women presenting with a clinically negative axilla. Am J Surg, 233, 45–51. https://doi.org/10.1016/j.amjsurg.2024.02.005
Botty van den Bruele, Astrid, Morgan A. Paul, Samantha M. Thomas, Sarah L. Sammons, Maggie L. DiNome, Jennifer K. Plichta, Sydney M. Record, et al. “Axillary nodal disease burden is not associated with an elevated 21-gene recurrence score in post-menopausal women presenting with a clinically negative axilla.Am J Surg 233 (July 2024): 45–51. https://doi.org/10.1016/j.amjsurg.2024.02.005.
Botty van den Bruele A, Paul MA, Thomas SM, Sammons SL, DiNome ML, Plichta JK, et al. Axillary nodal disease burden is not associated with an elevated 21-gene recurrence score in post-menopausal women presenting with a clinically negative axilla. Am J Surg. 2024 Jul;233:45–51.
Botty van den Bruele, Astrid, et al. “Axillary nodal disease burden is not associated with an elevated 21-gene recurrence score in post-menopausal women presenting with a clinically negative axilla.Am J Surg, vol. 233, July 2024, pp. 45–51. Pubmed, doi:10.1016/j.amjsurg.2024.02.005.
Botty van den Bruele A, Paul MA, Thomas SM, Sammons SL, DiNome ML, Plichta JK, Record SM, Woriax H, Chiba A, Rosenberger LH, Hwang ES. Axillary nodal disease burden is not associated with an elevated 21-gene recurrence score in post-menopausal women presenting with a clinically negative axilla. Am J Surg. 2024 Jul;233:45–51.
Journal cover image

Published In

Am J Surg

DOI

EISSN

1879-1883

Publication Date

July 2024

Volume

233

Start / End Page

45 / 51

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Prognosis
  • Postmenopause
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Lymphatic Metastasis
  • Lymph Nodes
  • Humans