Cáncer de mama: valor pronóstico del estado «TN» versus perfil de expresión génica tumoral

Abstract

Objectives

To analyze the prognostic value of the “TNM” system, and specifically the “TN” status, compared to the tumor gene expression profile, when evaluating the risk of metastatic disease.

Materials and methods

Retrospective review of 224 cases of infiltrating breast cancer. Genomic risk was established using the 70-gene gene expression platform (MammaPrint®). The result obtained with the genomic risk assessment has been considered “gold standard”.

Results

126 cases (56.25%) showed a “low” risk genomic profile and 98 cases (43.75%) showed a “high” risk. Among those with low genomic risk, 26.19% of tumors classified “T2”, “T3” and “T4” were observed. On the contrary, among those with “high” risk, 67.35% of tumors classified as “T1” were observed. Regarding the “N” status, among the “low” risk tumors, 26.98% of cases classified as “N1”, “N2” and “N3” were observed. On the other hand, among those with “high” genomic risk, 77.14% of cases classified as “N0” were observed. Among a total of 131 “T1N0” tumors, 57 (43.51%) showed “high” genomic risk. No significant differences have been observed in terms of risk assessment of metastatic disease (high vs. low) between the various “TN” categories studied.

Conclusions

The evaluation of the risk of metastatic disease using the “TN” system is not accurate. The detection of early tumors does not necessarily mean a good prognosis. On the contrary, the detection of “T2” or “N1” tumors does not imply a poor prognosis in all cases.