Distribution and molecular drivers of the 21-gene recurrence score in early breast cancer with low, intermediate, and high estrogen receptor expression - Summary - MDSpire
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Distribution and molecular drivers of the 21-gene recurrence score in early breast cancer with low, intermediate, and high estrogen receptor expression
To evaluate the distribution and molecular drivers of the 21-gene recurrence score (RS) in ER-positive, HER2-negative early breast cancer with low, intermediate, and high estrogen receptor (ER) expression.
Key Findings:
Mean RS values were 39 (ER-low), 32 (ER-intermediate), and 24 (ER-high), with significant differences (P < 0.001).
72.9% of ER-low patients had RS >25, with higher rates in younger patients and those with high clinical risk.
Expression of key genes (ESR1, PGR, BCL2, SCUBE2, STMY3) was significantly lower in ER-low compared to ER-high tumors (P < 0.001 for ESR1 and PGR, P = 0.035 for BCL2, P < 0.001 for SCUBE2, P = 0.001 for STMY3).
Only 8.83% of RS variance in ER-low tumors was explained by the four gene modules.
Interpretation:
The 21-gene RS was higher in ER-low breast cancer patients, particularly among those ≤50 years, indicating a potential need for tailored treatment strategies despite the moderate correlation with proliferation features.
Limitations:
Findings are exploratory and require validation in larger cohorts.
The study is retrospective and may be subject to selection bias, limiting causal inferences.
Conclusion:
The study highlights the complexity of ER-low breast cancer and suggests that the 21-gene assay may have limited utility in this subgroup, necessitating further research.
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