Evidence map›Paper›PMID 35810223›Full record

ArticleAnnals of surgical oncology2022

The 21-Gene Recurrence Score in Clinically High-Risk Lobular and Ductal Breast Cancer: A National Cancer Database Study.

Mary Kathryn Abel, Amy M Shui, A Jo Chien, Hope S Rugo, Michelle Melisko, Frederick Baehner, Rita A Mukhtar

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

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  12. Response to Maltoni, Puccetti, Poli, et al.Journal of the National Cancer Institute · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Mary Kathryn AbelSchool of Medicine, University of California, San Francisco, CA, USA.
Amy M ShuiDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
A Jo ChienDepartment of Medicine, San Francisco Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
Hope S RugoDepartment of Medicine, San Francisco Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
Michelle MeliskoDepartment of Medicine, San Francisco Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
Frederick BaehnerDepartment of Pathology, University of California, San Francisco, CA, USA.
Rita A MukhtarDepartment of Surgery, University of California, 1825 4th Street, 3rd Floor, Box 1710, San Francisco, CA, 94143, USA. rita.mukhtar@ucsf.edu.
University of California, San Francisco · USUCSF Helen Diller Family Comprehensive Cancer Center · US

Funding

Identifying responders to chemotherapy in invasive lobular carcinoma of the breast: development of a multivariable clinical prediction toolK08CA256047 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MUKHTAR, RITA · 2021 to 2025
$1.3M
NCI NIH HHS K08 CA256047NCI NIH HHS K08CA256047
6 · The paper itself

Abstract

objectiveThe aim of this study was to evaluate whether patients with invasive lobular carcinoma (ILC) are more likely to have discordant clinical and genomic risk than those with invasive ductal carcinoma (IDC) when using the 21-gene recurrence score (RS), and to assess overall survival outcomes of patients with 1-3 positive nodes and RS ≤25 with and without chemotherapy, stratified by histology.

methodsWe performed a cohort study using the National Cancer Database and included patients with hormone receptor-positive, HER2-negative, stage I-III invasive breast cancer who underwent 21-gene RS testing. Our primary outcome was rate of discordant clinical and genomic risk status by histologic subtype. Propensity score matching was used to compare 60-month overall survival in individuals with 1-3 positive nodes and RS ≤25 who did and did not receive chemotherapy.

resultsOverall, 186,867 patients were included in our analysis, including 37,685 (20.2%) patients with ILC. There was a significantly higher rate of discordant clinical and genomic risk in patients with ILC compared with IDC. Among patients with 1-3 positive nodes and RS ≤25, there was no significant difference in survival between those who did and did not receive chemotherapy in the IDC or ILC cohorts. Unadjusted exploratory analyses of patients under age 50 years with 1-3 positive nodes and RS ≤25 showed improved overall survival in IDC patients who received chemotherapy, but not among those with ILC.

conclusionOur findings highlight the importance of lobular-specific tools for stratifying clinical and genomic risk, as well as the need for histologic subtype-specific analyses in randomized trials.

Indexed as

Breast NeoplasmsCarcinoma, Ductal, BreastCarcinoma, LobularCohort StudiesDatabases, FactualFemaleHumansMiddle Aged

Identifiers

PMID35810223
PMCPMC9550696
OpenAlexW4284989736

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.