Recent outcome data including those from the prospective TAILORx trial strongly confirmed the RS role in node negative (N0) ER+ BC. The prospective WSG PlanB study showed excellent outcomes in high-risk N0 and node-positive (N+) pts with RS ≤ 11 and no adjuvant chemotherapy (CT). Physicians are increasingly using the RS for treatment decisions in N+ BC. We evaluated treatment and clinical outcomes in N+ pts undergoing RS testing through Clalit Health Services (CHS).
Medical records of all CHS pts with N+ ER+ HER2- BC who were tested between 1/2008 and 12/2011 were reviewed to verify treatment given and recurrence/death status. Interim results are presented herein. Final cohort results (>700 pts) will be presented at the meeting.
The current analysis includes 627 pts. Median age, 61 (34-87) yrs; 270 (43%) were N1mi, whereas 231 (37%) and 126 (20%) had 1 and 2-3, positive nodes, respectively. Grade 1 (15%), 2 (53%), 3 (16%), N/A (16%); histology, IDC (82%), lobular (12%), other (6%). With a median follow-up of 5.7 yrs, proportion of patients with distant recurrence (DR)/BC death by Paik et al and TAILORx RS categorization and by nodal status are presented in the Table. As pts were not randomized to treatment, analysis of DR/BC death by CT use is only exploratory: within the RS 18-30 group, CT-untreated pts (60%) had DR rate and BC death rate of 9.6% and 3.7%, respectively, whereas in CT-treated pts (40%) these rates were 2.2% and 1.1%; within the RS 11-25 group, CT-untreated pts (82%) had DR rate and BC death rate of 4.1% and 1.2%, respectively, whereas in CT-treated pts (18%) these rates were 2.7% and 0%.