The influence of gene expression profiling on decisional conflict in decision making for early-stage breast cancer chemotherapy

2016 ◽  
Vol 61 ◽  
pp. 85-93 ◽  
Author(s):  
Karen V. MacDonald ◽  
Yvonne Bombard ◽  
Ken Deal ◽  
Maureen Trudeau ◽  
Natasha Leighl ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Decision Making ◽  
Gene Expression Profiling ◽  
Cancer Chemotherapy ◽  
Expression Profiling ◽  
Early Stage ◽  
Decisional Conflict ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Chemotherapy

scholarly journals Underutilization of gene expression profiling for early-stage breast cancer in California

2016 ◽  
Vol 27 (6) ◽  
pp. 721-727 ◽  
Author(s):  
Rosemary D. Cress ◽  
Yingjia S. Chen ◽  
Cyllene R. Morris ◽  
Helen Chew ◽  
Kenneth W. Kizer
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Gene Expression Profiling ◽  
Expression Profiling ◽  
Early Stage ◽  
Early Stage Breast Cancer

scholarly journals Optimizing the Use of Gene Expression Profiling in Early-Stage Breast Cancer

2016 ◽  
Vol 34 (36) ◽  
pp. 4390-4397 ◽  
Author(s):  
Hyun-seok Kim ◽  
Christopher B. Umbricht ◽  
Peter B. Illei ◽  
Ashley Cimino-Mathews ◽  
Soonweng Cho ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Decision Making ◽  
Gene Expression Profiling ◽  
Expression Profiling ◽  
Early Stage ◽  
Recurrence Score ◽  
Clinical Samples ◽  
Risk Category ◽  
Clinical Risk

Purpose Gene expression profiling assays are frequently used to guide adjuvant chemotherapy decisions in hormone receptor–positive, lymph node–negative breast cancer. We hypothesized that the clinical value of these new tools would be more fully realized when appropriately integrated with high-quality clinicopathologic data. Hence, we developed a model that uses routine pathologic parameters to estimate Oncotype DX recurrence score (ODX RS) and independently tested its ability to predict ODX RS in clinical samples. Patients and Methods We retrospectively reviewed ordered ODX RS and pathology reports from five institutions (n = 1,113) between 2006 and 2013. We used locally performed histopathologic markers (estrogen receptor, progesterone receptor, Ki-67, human epidermal growth factor receptor 2, and Elston grade) to develop models that predict RS-based risk categories. Ordering patterns at one site were evaluated under an integrated decision-making model incorporating clinical treatment guidelines, immunohistochemistry markers, and ODX. Final locked models were independently tested (n = 472). Results Distribution of RS was similar across sites and to reported clinical practice experience and stable over time. Histopathologic markers alone determined risk category with > 95% confidence in > 55% (616 of 1,113) of cases. Application of the integrated decision model to one site indicated that the frequency of testing would not have changed overall, although ordering patterns would have changed substantially with less testing of estimated clinical risk–high or clinical risk–low cases and more testing of clinical risk–intermediate cases. In the validation set, the model correctly predicted risk category in 52.5% (248 of 472). Conclusion The proposed model accurately predicts high- and low-risk RS categories (> 25 or ≤ 25) in a majority of cases. Integrating histopathologic and molecular information into the decision-making process allows refocusing the use of new molecular tools to cases with uncertain risk.

Systematic Review: Gene Expression Profiling Assays in Early-Stage Breast Cancer

2008 ◽  
Vol 148 (5) ◽  
pp. 358 ◽  
Author(s):  
Luigi Marchionni ◽  
Renee F. Wilson ◽  
Antonio C. Wolff ◽  
Spyridon Marinopoulos ◽  
Giovanni Parmigiani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Systematic Review ◽  
Gene Expression Profiling ◽  
Expression Profiling ◽  
Early Stage ◽  
Early Stage Breast Cancer
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