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Breast-malignant, males, children
Breast cancer - Prognostic factors - Multigene products
Author: Nat Pernick, M.D, PathologyOutlines.com, Inc.
Reviewer: Daniel Visscher, M.D., University of Michigan Hospitals, February 2009 (see Reviewers page)
Revised: 20 September 2009
Last major update: September 2009
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Features
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● Gene expression profiles are associated with overall survival for several tumor types, including breast (N Engl J Med 2007;356:217)
● Several multigene prognostic products are commercially successful, including oncotype DXTM and MammaPrint® (Oncologist 2008;13:477, Adv Anat Pathol 2009;16:204)
● US Food and Drug Administration has new in vitro diagnostic multivariate index assay (IVDMIA) classification for these tests (link)
● For all tests, the relationship of predicted to observed risk in different populations and their incremental contribution over conventional predictors, optimal implementation, and relevance to patients receiving current therapies need further study (Ann Intern Med 2008;148:358, Ann Oncol 2007;18 Suppl 6:vi58, Genet Med 2009;11:66)
MammaPrint®
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● Prognostic test for women under age of 61 years with lymph node-negative breast cancer (ER positive or negative)
● Requires freshly prepared tissue collected in RNA preservative solution
● Uses 70 genes that comprise the assay are focused on proliferation, plus invasion, metastasis, stromal integrity and angiogenesis.
Oncotype DX TM
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● First available in January 2004
● Measures changes in 21 genes to predict likelihood of disease recurrence and which patients are most likely to respond to chemotherapy (Breast Cancer Res 2006;8:R25)
● Recurrence score is used for some patients with ER+, node negative breast cancer
● Recurrence score is associated with real world decision changes (Am J Surg 2008;196:527, J Surg Oncol 2009;99:319)
Sources for testing (advertisements)
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● Genzyme
End of Breast – Malignant, Males, Children > Breast cancer - Prognostic factors > Multigene products
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