MammaPrint Pre-screen Algorithm (MPA) reduces chemotherapy in patients with early-stage breast cancer

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dc.contributor.authorGrant, Kathleen A.en_ZA
dc.contributor.authorApffelstaedt, Justus P.en_ZA
dc.contributor.authorWright, Colleen A.en_ZA
dc.contributor.authorMyburgh, Ettienneen_ZA
dc.contributor.authorPienaar, Rikaen_ZA
dc.contributor.authorDe Klerk, Manieen_ZA
dc.contributor.authorKotze, Maritha J.en_ZA
dc.date.accessioned2014-07-07T12:10:21Z
dc.date.available2014-07-07T12:10:21Z
dc.date.issued2013-07-03
dc.descriptionCITATION: Grant, K. A. et al. 2013. MammaPrint Pre-screen Algorithm (MPA) reduces chemotherapy in patients with early-stage breast cancer. South African Medical Journal, 103(8):522-526, doi:10.7196/SAMJ.7223.en_ZA
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractBackground. Clinical and pathological parameters may overestimate the need for chemotherapy in patients with early-stage breast cancer. More accurate determination of the risk of distant recurrence is now possible with use of genetic tests, such as the 70-gene MammaPrint profile. Objectives. A health technology assessment performed by a medical insurer in 2009 introduced a set of test eligibility criteria – the MammaPrint Pre-screen Algorithm (MPA) – applied in this study to determine the clinical usefulness of a pathology-supported genetic testing strategy, aimed at the reduction of healthcare costs. Methods. An implementation study was designed to take advantage of the fact that the 70-gene profile excludes analysis of hormone receptor and human epidermal growth factor receptor 2 (HER2) status, which form part of the MPA based partly on immunohistochemistry routinely performed in all breast cancer patients. The study population consisted of 104 South African women with early-stage breast carcinoma referred for MammaPrint. For the MammaPrint test, RNA was extracted from 60 fresh tumours (in 58 patients) and 46 formalin-fixed, paraffin-embedded (FFPE) tissue samples. Results. When applying the MPA for selection of patients eligible for MammaPrint testing, 95 of the 104 patients qualified. In this subgroup 62% (59/95) were classified as low risk. Similar distribution patterns for risk classification were obtained for RNA extracted from fresh tumours v. FFPE tissue samples. Conclusions. The 70-gene profile classifies approximately 40% of early-stage breast cancer patients as low-risk compared with 15% using conventional criteria. In comparison, more than 60% were shown to be low risk with use of the MPA validated in this study as an appropriate strategy to prevent chemotherapy overtreatment in patients with early-stage breast cancer.en_ZA
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/7223
dc.description.versionPublisher's version
dc.format.extent5 pages
dc.identifier.citationGrant, K. A. et al. 2013. MammaPrint Pre-screen Algorithm (MPA) reduces chemotherapy in patients with early-stage breast cancer. South African Medical Journal, 103(8):522-526, doi:10.7196/SAMJ.7223.
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJ.7223
dc.identifier.urihttp://hdl.handle.net/10019.1/91583
dc.language.isoen_ZA
dc.publisherHealth & Medical Publishing Group
dc.rights.holderAuthors retain copyright
dc.subjectMammaPrint Pre-screen Algorithmen_ZA
dc.subjectBreast -- Canceren_ZA
dc.subjectGene profilingen_ZA
dc.subjectChemotherapy -- Overtreatmenten_ZA
dc.subjectHuman chromosome abnormalities -- Diagnosisen_ZA
dc.titleMammaPrint Pre-screen Algorithm (MPA) reduces chemotherapy in patients with early-stage breast canceren_ZA
dc.typeArticle
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