Correlation between modified Magee equation-2 and Oncotype-Dx recurrence scores using both traditional and TAILORx cutof
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ORIGINAL ARTICLE
Correlation between modified Magee equation‑2 and Oncotype‑Dx recurrence scores using both traditional and TAILORx cutoffs and the clinical application of the Magee Decision Algorithm: a single institutional review Akisha Glasgow1 · Haley Sechrist2 · Phillip Bomeisl1 · Hannah Gilmore1 · Aparna Harbhajanka1 Received: 14 May 2020 / Accepted: 11 September 2020 © The Japanese Breast Cancer Society 2020
Abstract Background Oncotype Dx (ODX) is used to predict recurrence risk for estrogen-positive (ER +), HER2-negative and lymph node negative breast cancer, however, due to the cost its use may be limited in low-resource areas. The aim of this study is to assess the concordance between the modified Magee Equation-2 (MME-2) and ODX recurrence scores (RS). The secondary aim is to apply the Magee Decision Algorithm (MDA) using the MME-2 to determine which patients are unlikely to benefit from ODX testing. Methods All newly diagnosed ER + , HER2 negative, lymph node negative breast cancer patients with available ODX-RS from 2008–2018 were included. The original pathology reports were reviewed and chart review was performed. The MME-2 scores were calculated and correlated with the ODX-RS. The MDA was applied to our cohort to assess which patients would not benefit from ODX testing. Results A total of 579 patients were included. There was an overall moderate correlation between ODX-RS and MME-2 score (Pearson correlation coefficient = 0.635). The overall concordance between ODX and MME-2 scores was similar when using both the traditional and TAILORx cutoffs (63.3% vs. 63.7%, respectively). Applying the MDA, for patients with MME-2 scores 25. Concordance was highest in the high-risk category using both cutoffs. For patients with MME-2 18–25 and a mitotic score of 1, 88.8% had the expected ODX-RS of > 25. Conclusion There is a moderate correlation between MME-2 score and ODX-RS. The overall concordance was similar for both traditional and TAILORx cutoffs. The strongest concordance was found in the high-risk category for both cutoffs. The MME-2 can be used to identify patients unlikely to benefit from ODX testing using the MDA. Keywords Breast cancer · Oncotype Dx · Magee equations · Magee Decision Algorithm
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12282-020-01163-3) contains supplementary material, which is available to authorized users. * Akisha Glasgow [email protected] 1
Department of Pathology, University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, Ohio, USA
School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
2
Breast cancer is the most common cancer found in women worldwide, and within the United States, it is the most common non-dermatologic cancer in women [1, 2]. Presently, early-staged, hormone receptor positive, lymph node negative breast cancer accounts for 50% of breast cancer cases diagnosed in the United States [3, 4]. The addition of adju
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