Evidence map›Paper›PMID 31116801›Full record

ArticlePloS one2019

Reclassification of breast cancer: Towards improved diagnosis and outcome.

Alexander P Landry, Zsolt Zador, Rashida Haq, Michael D Cusimano

Abstract read
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

4 authors.

Alexander P LandryDepartment of Surgery, St. Michael's Hospital, Toronto, ON, Canada.ORCID 0000-0002-7250-8466
Zsolt ZadorDepartment of Surgery, St. Michael's Hospital, Toronto, ON, Canada.ORCID 0000-0001-9767-3372
Rashida HaqDivision of Hematology/Oncology, St. Michael's Hospital, Toronto, ON, Canada.
Michael D CusimanoDepartment of Surgery, St. Michael's Hospital, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe subtyping of breast cancer based on features of tumour biology such as hormonal receptor and HER2 status has led to increasingly patient-specific treatment and thus improved outcomes. However, such subgroups may not be sufficiently informed to best predict outcome and/or treatment response. The incorporation of multi-modal data may identify unexpected and actionable subgroups to enhance disease understanding and improve outcomes.

methodsThis retrospective cross-sectional study used the cancer registry Surveillance, Epidemiology and End Results (SEER), which represents 28% of the U.S. population. We included adult female patients diagnosed with breast cancer in 2010. Latent class analysis (LCA), a data-driven technique, was used to identify clinically homogeneous subgroups ("endophenotypes") of breast cancer from receptor status (hormonal receptor and HER2), clinical, and demographic data and each subgroup was explored using Bayesian networks.

resultsIncluded were 44,346 patients, 1257 (3%) of whom had distant organ metastases at diagnosis. Four endophenotypes were identified with LCA: 1) "Favourable biology" had entirely local disease with favourable biology, 2) "HGHR-" had the highest incidence of HR- receptor status and highest grade but few metastases and relatively good outcomes, 3) "HR+ bone" had isolated bone metastases and uniform receptor status (HR+/HER2-), and 4) "Distant organ spread" had high metastatic burden and poor survival. Bayesian networks revealed clinically intuitive interactions between patient and disease features.

conclusionsWe have identified four distinct subgroups of breast cancer using LCA, including one unexpected group with good outcomes despite having the highest average histologic grade and rate of HR- tumours. Deeper understanding of subgroup characteristics can allow us to 1) identify actionable group properties relating to disease biology and patient features and 2) develop group-specific diagnostics and treatments.

Indexed as

AdultAgedBayes TheoremBiomarkers, TumorBone NeoplasmsBreast NeoplasmsCross-Sectional StudiesErb-b2 Receptor Tyrosine KinasesFemaleHumansIncidenceLatent Class AnalysisMiddle AgedNeoplasm MetastasisPhenotypeProbabilityBiomarkers, TumorERBB2 protein, humanErb-b2 Receptor Tyrosine Kinases

Identifiers

PMID31116801
PMCPMC6530843

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.