Ann Surg Treat Res.  2025 Apr;108(4):219-230. 10.4174/astr.2025.108.4.219.

Characteristics of premenopausal breast cancer patients with a midrange 21-gene recurrence score

• Park JM
• Lee SJ
• Ahn JH
• Yoon CS
• Park S

• KMID: 2566625
• DOI: http://doi.org/10.4174/astr.2025.108.4.219

Abstract

Purpose
The results of the TAILORx trial have shown that premenopausal patients with intermediate Oncotype Dx (ODx) recurrence score of 16–25 may benefit from adjuvant chemotherapy. In addition, the clinicopathological features showed the information complementary to ODx results. However, the characteristics may vary depending on menopausal status even in the same score. This study aimed to analyze the differences in the clinical characteristics by menopausal status.
Methods
This study conducted a retrospective analysis of 756 patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-negative breast cancer who underwent the ODx test from July 2013 to December 2020 at the Severance Hospital.
Results
Of the 756 patients, 261 patients were postmenopausal, and 495 were premenopausal. The premenopausal patients with a midrange ODx had similar clinicopathological features as compared to those with a high ODx. Conversely, the postmenopausal patients with a midrange ODx did not show significantly different clinicopathological features from those with a low ODx, whereas a difference was seen as compared to those with a high ODx.
Conclusion
In this study, unlike the postmenopausal patients, some of the clinicopathological characteristics of the premenopausal patients with a midrange ODx were closer to those with a high ODx than those with a low ODx. In the premenopausal patients with a midrange ODx, considering the baseline characteristic itself, there was a significant difference between those with a low ODx when compared with postmenopausal patients. Therefore, more aggressive treatment decisions may be helpful in premenopausal patients with a midrange ODx.

Keyword

Breast neoplasms; Clinical features; Gene expression profiling; Postmenopause; Premenopause