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A Supervised Risk Predictor of Breast Cancer Based on Biological Subtypes

ABSTRACT: Purpose: The biological subtypes of breast cancer designated as Luminal A, Luminal B, HER2+/ER-, and Basal-like are clinically important for prognosis and planning treatment strategies. Recognizing that there is a continuum in both the spectrum of breast cancer disease and the risk of survival, we sought to develop a clinical test for the biological subtypes using a supervised risk classier.Methods: Microarray and real-time quantitative RT-PCR (qRT-PCR) data from 189 samples, procured as fresh-frozen and formalin-fixed, paraffin-embedded tissues, were used to statistically select prototypical samples and genes for the biological subtypes of breast cancer. Predictions for biological subtype and risk of recurrence were determined for different stages of disease, treatments, and across analytical platforms. Results: The biological subtype predictions on a large combined microarray test set showed prognostic significance across all patients (1244 subjects; p<0.0001), on node negative patients with no adjuvant systemic therapy (738 subjects; p<0.0001), and on patients treated with endocrine therapy (404 subjects; p=0.001). Analysis of a neoadjuvant chemotherapy study revealed a high pathologic complete response (pCR) rate in HER2+/ER- and Basal-like patients. The subtype and risk predications were also highly significant when using the qRT-PCR assay from archived FFPE breast cancers. Conclusion: Our risk predictor based on distance to biological subtype centroids provides a continuous risk score that applies to all stages of breast cancer given current therapies. The assay can be performed using archived breast tissues and a real-time qRT-PCR assay, thus facilitating application to retrospective cohorts and clinical samples. Keywords: reference x sample

ORGANISM(S): Homo sapiens

PROVIDER: GSE10886 | GEO | 2009/02/11

SECONDARY ACCESSION(S): PRJNA107283

REPOSITORIES: GEO

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Project description:Ductal carcinoma in situ (DCIS) is a non-invasive form of breast cancer where cells restricted to the ducts exhibit an atypical phenotype. Some DCIS lesions are believed to rapidly transit to invasive ductal carcinomas (IDCs), while others remain unchanged. Existing classification systems for DCIS fail to identify those lesions that transit to IDC. We studied gene expression patterns of 31 pure DCIS, 36 pure invasive cancers and 42 cases of mixed diagnosis (invasive cancer with an in situ component) using Agilent Whole Human Genome Oligo Microarrays 44k. Six normal breast tissue samples were also included as controls. qRT-PCR was used for validation. All DCIS and invasive samples could be classified into the intrinsic molecular subtypes defined for invasive breast cancer. Hierarchical clustering establishes that samples group by intrinsic subtype, and not by diagnosis. We observed heterogeneity in the transcriptomes among DCIS of high histological grade and identified a distinct subgroup containing seven of the 31 DCIS samples with gene expression characteristics more similar to advanced tumours. A set of genes independent of grade, ER-status and HER2-status was identified by logistic regression that univariately classified a sample as belonging to this distinct DCIS subgroup. qRT-PCR of single markers clearly separated this DCIS subgroup from the other DCIS, and contains samples from several histopathological and intrinsic molecular subtypes. The genes that differentiate between these two types of DCIS suggest several processes related to the re-organisation of the microenvironment. This raises interesting possibilities for identification of DCIS lesions both with and without invasive characteristics, which potentially could be used in clinical assessment of a woman's risk of progression, and lead to improved management that would avoid the current over- and under-treatment of patients. Breast cancer samples, 31 pure DCIS patients, 36 IDC patients, 42 mixed and 6 normal.

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A Supervised Risk Predictor of Breast Cancer Based on Biological Subtypes

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