Threshold for Breast Cancer Recurrence Score Differs by Sex
Increased mortality seen at lower ranges of Oncotype DX Breast Recurrence Score for men versus women
THURSDAY, Nov. 21, 2019 (HealthDay News) -- The Oncotype DX Breast Recurrence Score (RS) is associated with mortality at a lower threshold for men versus women with breast cancer, according to a study published online Nov. 20 in Clinical Cancer Research.
Fei Wang, M.D., Ph.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues identified a cohort of 848 male and 110,898 female patients with breast cancer. The hazard ratios for overall mortality associated with RS were estimated. RS was assessed continuously and according to traditional (≤17, 18 to 30, and ≥31) and TAILORx (≤10, 11 to 25, and ≥26) cutoffs.
The researchers found that in male patients, RS was positively associated with mortality (hazard ratio, 1.13 per unit RS increment) up to RS >21 after which the risk plateaued. Mortality began to increase among female patients only when RS >23 (hazard ratio, 1.02 per RS unit increment). Elevated mortality risk was seen in men for intermediate-risk and high-risk diseases defined by TAILORx (hazard ratios, 5.37 and 4.28, respectively), but not traditional cutoffs established for female patients even after adjustment for demographics, clinical characteristics, and treatments except chemotherapy.
"Mortality increased in much lower ranges of RS for male than female patients with breast cancer," the authors write. "Studies are needed to develop RS categorization specifically for male patients with breast cancer."
One author disclosed financial ties to the biopharmaceutical industry.