ReviewAnnals of oncology : official journal of the European Society for Medical Oncology2019
Avoiding over- and undertreatment in patients with resected node-positive breast cancer with the use of gene expression signatures: are we there yet?
Review in Annals of oncology : official journal of the European Society for Medical Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 38 citations in OpenAlex.
- Development and validation of a machine learning clinicogenomic model to improve prognostic stratification in ER-positive/HER2-negative early breast cancer.Breast cancer research : BCR · 2026Article
- Pharmacologic management of HR+/HER2- mBC: a clinically oriented review.Frontiers in oncology · 2025Review
- Breast cancer during pregnancy-The oncologist's point of view.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Impact of De Novo Cholesterol Biosynthesis on the Initiation and Progression of Breast Cancer.Biomolecules · 2024Review
- Application of a 21-Gene Recurrence Score in a Swiss Single-Center Breast Cancer Population: A Comparative Analysis of Treatment Administration before and after TAILORx.Diagnostics (Basel, Switzerland) · 2023Article
- The Role of Nodes and Nodal Assessment in Diagnosis, Treatment and Prediction in ER+, Node-Positive Breast Cancer.Journal of personalized medicine · 2023Review
- Prognostic and predictive impact of gene expression in node-positive early breast cancer patients receiving dose-dense versus standard-dose adjuvant chemotherapy.Molecular oncology · 2023Article
- Development of Tier 2 LC-MRM-MS protein quantification methods for liquid biopsies.Journal of mass spectrometry and advances in the clinical lab · 2023Article
- Understanding Breast Cancers through Spatial and High-Resolution Visualization Using Imaging Technologies.Cancers · 2022Review
- Real World Evaluation of the Prosigna/PAM50 Test in a Node-Negative Postmenopausal Swedish Population: A Multicenter Study.Cancers · 2022Article
- Outcome analysis of primary breast cancer patients who declined adjuvant chemotherapy-results from the prospective multi-center BRENDA II study.Breast cancer (Tokyo, Japan) · 2022Article
- Immediate Skin Replacement Allows for Nipple-sparing, Direct-to-implant Reconstruction in Patients with Advanced Breast Cancers.Plastic and reconstructive surgery. Global open · 2022Article
- Identifying Clinicopathological Factors Associated with Oncotype DXJournal of personalized medicine · 2021Article
- Prognostic Significance ofDiagnostics (Basel, Switzerland) · 2021Article
- Cancer Grade Model: a multi-gene machine learning-based risk classification for improving prognosis in breast cancer.British journal of cancer · 2021Article
- Review
- How Canadian Oncologists Use Oncotype DX for Treatment of Breast Cancer Patients.Current oncology (Toronto, Ont.) · 2021Article
- The 21-gene recurrence score in node-positive, hormone receptor-positive, HER2-negative breast cancer: a cautionary tale from an NCDB analysis.Breast cancer research and treatment · 2021Article
- Comparison of breast cancer prognostic tests CanAssist Breast and Oncotype DX.Cancer medicine · 2020Article
- Novel quantitative signature of tumor stromal architecture: polarized light imaging differentiates between myxoid and sclerotic human breast cancer stroma.Biomedical optics express · 2020Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prediction of benefit from adjuvant chemotherapy following resection of early breast cancer and, as a result, proper selection of candidates remains an elusive goal since the relative magnitude of benefit is the same regardless of the presence of clinicopathologic factors. Multiple studies, including randomized trials, establish the role of certain gene expression signatures in node-negative disease since they predict the risk of breast cancer relapse being so low that adjuvant chemotherapy can be omitted. In contrast, more limited data are available in higher risk, node-positive breast cancer patients, making the exclusion of adjuvant chemotherapy potentially hazardous. 'Prospective-retrospective' studies and limited prospective data show that several signatures, namely Oncotype Dx, MammaPrint, Prosigna, EndoPredict and Breast Cancer Index, select with different levels of success node-positive patients at very low risk for distant recurrence despite not receiving chemotherapy, although the long-term follow-up is still awaited. Pending, however the publication of the results from ongoing randomized studies which enroll patients with node-positive disease, major caution is warranted. Improper use and misinterpretation of these transcriptomic profiles can lead to undertreatment and exposure of patients to unnecessary risks resulting in increased breast cancer mortality for patients with axillary node-positive disease. With this review we critically discuss the available data on gene expression signatures that are used in clinical practice and offer practical recommendations regarding the management of patients with ER-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-positive breast cancer.
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