Outcome disparities by age and 21-gene recurrence score® (RS) result in hormone receptor positive (HR+) breast cancer (BC)

Background

BC diagnoses in older patients (pts) are rising as population demographics change and life expectancy increases. The multinational TEAM study (N = 9,766) reported worse outcomes for older pts with HR+ BC (JAMA. 2012;307:590). To confirm this finding and to examine the role of tumor biology, SEER and Genomic Health collaborated to electronically supplement SEER registries with RS results and evaluate BC-specific mortality (BCSM).

Methods

21-gene RS results were provided to the NCI-sponsored SEER registries and linked to SEER BC cases. Eligible pts were diagnosed (Jan 2004 – Dec 2011) with N0 HR+ BC, and had no prior malignancy or multiple tumors. BCSM, defined previously (JNCI. 2010;102:1584), was analyzed separately for pts

Results

Of 184,190 eligible pts, 70%/30% were  1-2 cm). Reported chemotherapy (CT) use and 5-y BCSM are shown in Table. CT use was lower for pts ≥70 y (p 

Conclusions

This large population-based observational study of N0 HR+ BC shows that unacceptably high BCSM persists in US clinical practice for pts ≥70 y with either no 21-gene assay done or an RS ≥18 (but not RS

Clinical trial identification

N/A

Legal entity responsible for the study

Steven Shak, Dave P. Miller, Lynne Penberthy, Valentina I. Petkov

Funding

National Cancer Institute

Disclosure

S. Shak, D.P. Miller, N. Gliner, F.L. Baehner: Employed by Genomic Health; stock ownership in Genomic Health. All other authors have declared no conflicts of interest.