Gene expression profiling spares early breast cancer patients from adjuvant therapy: derived and validated in two population-based cohorts.

摘要: Adjuvant breast cancer therapy significantly improves survival, but overtreatment and undertreatment are major problems. Breast expression profiling has so far mainly been used to identify women with a poor prognosis as candidates for adjuvant without demonstrated value prediction. We obtained the gene profiles of 159 population-derived patients, hierarchical clustering signature associated impact therapies, defined distant metastasis or death within 5 years. Independent datasets 76 treated Swedish 135 untreated patients 78 Dutch were validation. The inclusion exclusion criteria studies defined. Among subset 64 genes was found give an optimal separation good outcomes. Hierarchical revealed three subgroups: who did well therapy, that failed benefit from given therapy. profile gave better prognostication (odds ratio, 4.19; P = 0.007) (breast end-points odds 10.64) compared Elston–Ellis histological grading ratio grade 2 vs 1 3 1, 2.81 3.32 respectively; 0.24 0.16), tumor stage 1.11 1.28; 0.83 0.68) age 0.11; 0.55). risk groups consistent validated in independent data sets 211 respectively. have identified discriminatory signatures working both on systematically primary potential spare them