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Annals of Oncology Advance Access published online on October 13, 2009
Annals of Oncology, doi:10.1093/annonc/mdp388
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

The 70-gene prognosis signature predicts early metastasis in breast cancer patients between 55 and 70 years of age

S. Mook1, M. K. Schmidt2, B. Weigelt3, B. Kreike4, I. Eekhout1, M. J. van de Vijver1, A. M. Glas5, A. Floore5, E. J. T. Rutgers6 and L. J. van ‘t Veer1,5,*

1 Department of Pathology
2 Department of Epidemiology
3 Department of Experimental Therapy
4 Department of Radiation Oncology, The Netherlands Cancer Institute
5 Department of Agendia BV
6 Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

* Correspondence to: Dr L. J. van ‘t Veer, Department of Pathology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. Tel: +31-20-5122754; Fax: +31-20-5122759; E-mail: l.vt.veer{at}nki.nl

Background: The majority of breast cancer patients are postmenopausal women who are increasingly being offered adjuvant chemotherapy. Since the beneficial effect of chemotherapy in postmenopausal patients predominantly occurs in the first 5 years after diagnosis, a prognostic marker for early events can be of use for adjuvant treatment decision making. The aim of this study was to evaluate the prognostic value of the 70-gene prognosis signature for early events in postmenopausal patients.

Methods: Frozen tumor samples from 148 patients aged 55–70 years were selected (T1–2, N0) and classified by the 70-gene prognosis signature (MammaPrintTM) into good or poor prognosis. Eighteen percent received hormonal therapy.

Results: Breast cancer-specific survival (BCSS) at 5 years was 99% for the good-prognosis signature versus 80% for the poor-prognosis signature group (P = 0.036). The 70-gene prognosis signature was a significant and independent predictor of BCCS during the first 5 years of follow-up with an adjusted hazard ratio of 14.4 (95% confidence interval 1.7–122.2; P = 0.01) at 5 years.

Conclusion: The 70-gene prognosis signature can accurately select postmenopausal patients at low risk of breast cancer-related death within 5 years of diagnosis and can be of clinical use in selecting postmenopausal women for adjuvant chemotherapy.

breast cancer, 70-gene prognosis signature, postmenopausal

Received for publication January 22, 2009. Accepted for publication July 6, 2009.


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