MammaPrint Pre-screen Algorithm (MPA) reduces chemotherapy in patients with early-stage breast cancer
dc.contributor.author | Grant, Kathleen A. | en_ZA |
dc.contributor.author | Apffelstaedt, Justus P. | en_ZA |
dc.contributor.author | Wright, Colleen A. | en_ZA |
dc.contributor.author | Myburgh, Ettienne | en_ZA |
dc.contributor.author | Pienaar, Rika | en_ZA |
dc.contributor.author | De Klerk, Manie | en_ZA |
dc.contributor.author | Kotze, Maritha J. | en_ZA |
dc.date.accessioned | 2014-07-07T12:10:21Z | |
dc.date.available | 2014-07-07T12:10:21Z | |
dc.date.issued | 2013-07-03 | |
dc.description | CITATION: 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.description | The original publication is available at http://www.samj.org.za | |
dc.description.abstract | Background. 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.uri | http://www.samj.org.za/index.php/samj/article/view/7223 | |
dc.description.version | Publisher's version | |
dc.format.extent | 5 pages | |
dc.identifier.citation | 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. | |
dc.identifier.issn | 2078-5135 (online) | |
dc.identifier.issn | 0256-9574 (print) | |
dc.identifier.other | doi:10.7196/SAMJ.7223 | |
dc.identifier.uri | http://hdl.handle.net/10019.1/91583 | |
dc.language.iso | en_ZA | |
dc.publisher | Health & Medical Publishing Group | |
dc.rights.holder | Authors retain copyright | |
dc.subject | MammaPrint Pre-screen Algorithm | en_ZA |
dc.subject | Breast -- Cancer | en_ZA |
dc.subject | Gene profiling | en_ZA |
dc.subject | Chemotherapy -- Overtreatment | en_ZA |
dc.subject | Human chromosome abnormalities -- Diagnosis | en_ZA |
dc.title | MammaPrint Pre-screen Algorithm (MPA) reduces chemotherapy in patients with early-stage breast cancer | en_ZA |
dc.type | Article |
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