Five years of transcriptional profiling of breast tumours in a South African cohort.
Article Type: Report
Subject: Chemotherapy (Methods)
DNA testing (Research)
Breast tumors (Diagnosis)
Breast tumors (Care and treatment)
Breast tumors (Demographic aspects)
Cancer (Chemotherapy)
Cancer (Methods)
Authors: Apffelstaedt, J.
Kotze, M.
Pub Date: 04/01/2011
Publication: Name: South African Journal of Surgery Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 South African Medical Association ISSN: 0038-2361
Issue: Date: April, 2011 Source Volume: 49 Source Issue: 2
Topic: Event Code: 310 Science & research Canadian Subject Form: Breast tumours; Breast tumours; Breast tumours
Geographic: Geographic Scope: South Africa Geographic Code: 6SOUT South Africa
Accession Number: 257675292
Full Text: Molecular prognostic profiling of breast tumours became commercially available in South Africa in 2006. We report the experience of applying a 70-gene expression profile (MammaPrint[R] (MP)) in a South African cohort.

For hormone receptor-positive TNM stage 0--II tumours in patients aged 35-70, fresh tumour samples were taken and gene expression profiled. Demographic data, tumour staging and detailed histopathology were recorded. Adjuvant therapy was based on MP results and compared with the St Gallen recommendations. Ten-year survival data were projected with either adjuvantonline or published data on MP.

From 2006, 17 tests failed owing to insufficient material. For 50 tumours, the clinical staging was 0 in 4, I in 34 and II in 12. The average histopathological tumour size was 16.5 mm, and 34 were node negative. Fifteen tumours were concordantly reported as high risk and 12 as low risk; 8 St Gallen low-risk tumours were reported as high risk by MP, and 15 St Gallen high-risk tumours were reported as low risk by MP. Chemotherapy was recommended for 30 patients according to St Gallen for an average absolute reduction of recurrence of 7.8% and mortality of 3.9%; MP prognostication led to a recommendation for chemotherapy for 23 patients for an absolute 12.3% reduction in recurrence and 6.9% for mortality. Two MP high-risk tumours and none of the low-risk tumours have recurred.

MP prognostication led to treatment changes in 46% of cases with a reduction in chemotherapy recommendations; it allocates chemotherapy more appropriately than histopathological parameters.

J Apffelstaedt, M Kotze

Stellenbosch University, W Cape
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