MammaPrint Feasibility in a Large Tertiary Urban Medical Center: An Initial Experience

Background. The MammaPrint (MP) diagnostic assay stratifies breast cancer patients into high- and low-risk groups using mRNA analysis of a 70-gene profile. The assay is validated for assessment of patients with estrogen receptor positive or negative tumors less than 5 cm with 3 or fewer malignant ly...

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Main Authors: C. Francisco Espinel, Shaughn Keating, Hanina Hibshoosh, Bret Taback, Kathie-Ann Joseph, Mahmoud El-Tamer, Sheldon Feldman
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Scientifica
Online Access:http://dx.doi.org/10.6064/2012/942507
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author C. Francisco Espinel
Shaughn Keating
Hanina Hibshoosh
Bret Taback
Kathie-Ann Joseph
Mahmoud El-Tamer
Sheldon Feldman
author_facet C. Francisco Espinel
Shaughn Keating
Hanina Hibshoosh
Bret Taback
Kathie-Ann Joseph
Mahmoud El-Tamer
Sheldon Feldman
author_sort C. Francisco Espinel
collection DOAJ
description Background. The MammaPrint (MP) diagnostic assay stratifies breast cancer patients into high- and low-risk groups using mRNA analysis of a 70-gene profile. The assay is validated for assessment of patients with estrogen receptor positive or negative tumors less than 5 cm with 3 or fewer malignant lymph nodes. TargetPrint (TP) is an assay for assessing estrogen, progesterone, and HER2-neu receptor status based on mRNA expression. A potential limitation of these assays is that they require an evaluation of fresh tissue samples. There is limited published experience describing MP or TP implementation. Methods. Over 10 months, 4 breast surgeons obtained samples from 54 patients for MP/TP analysis. The samples were analyzed by Agendia Labs. The tumors were independently evaluated for receptor status using immunohistochemistry (IHC). Retrospectively, we identified patients who were assessed by MP/TP during this period. Patients who underwent OncotypeDx evaluation were also identified. Results. Of the 54 patients receiving MP, 4 were found ineligible for MP risk assessment because >3 lymph nodes were found to be malignant. Out of all eligible patients, 14/50 (28%) had samples whose quantity of tumor was not sufficient for analysis (QNS). Out of eligible patients with tumors <1 cm, 7/8 (88%) had QNS samples. 7/42 with tumors ≥1 cm (17%) had QNS samples. Nine patients had discordant receptor results when evaluated by IHC versus. TP. Of patients who also underwent OncotypeDx testing, 6/14 (43%) had discordant results with MP. Conclusions. This study indicates that using MP/TP assay is feasible in a tertiary care center but there may be utility in limiting MP testing to patients with tumors between 1 and 5 cm due to high likelihood of uninformative results in subcentimeter tumors. Further study is needed to explore the discordance between oncotype and MP results.
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spelling doaj-art-6a4f2dc4d2134ee1bbb5711f18c15acc2025-02-03T01:25:28ZengWileyScientifica2090-908X2012-01-01201210.6064/2012/942507942507MammaPrint Feasibility in a Large Tertiary Urban Medical Center: An Initial ExperienceC. Francisco Espinel0Shaughn Keating1Hanina Hibshoosh2Bret Taback3Kathie-Ann Joseph4Mahmoud El-Tamer5Sheldon Feldman6Division of Breast Surgery, Department of Surgery, Columbia University Comprehensive Breast Center, New York, NY 10032, USAColumbia University College of Physicians and Surgeons, New York, NY, USADivision of Breast Surgery, Department of Surgery, Columbia University Comprehensive Breast Center, New York, NY 10032, USADivision of Breast Surgery, Department of Surgery, Columbia University Comprehensive Breast Center, New York, NY 10032, USADivision of Breast Surgery, Department of Surgery, Columbia University Comprehensive Breast Center, New York, NY 10032, USADivision of Breast Surgery, Department of Surgery, Columbia University Comprehensive Breast Center, New York, NY 10032, USADivision of Breast Surgery, Department of Surgery, Columbia University Comprehensive Breast Center, New York, NY 10032, USABackground. The MammaPrint (MP) diagnostic assay stratifies breast cancer patients into high- and low-risk groups using mRNA analysis of a 70-gene profile. The assay is validated for assessment of patients with estrogen receptor positive or negative tumors less than 5 cm with 3 or fewer malignant lymph nodes. TargetPrint (TP) is an assay for assessing estrogen, progesterone, and HER2-neu receptor status based on mRNA expression. A potential limitation of these assays is that they require an evaluation of fresh tissue samples. There is limited published experience describing MP or TP implementation. Methods. Over 10 months, 4 breast surgeons obtained samples from 54 patients for MP/TP analysis. The samples were analyzed by Agendia Labs. The tumors were independently evaluated for receptor status using immunohistochemistry (IHC). Retrospectively, we identified patients who were assessed by MP/TP during this period. Patients who underwent OncotypeDx evaluation were also identified. Results. Of the 54 patients receiving MP, 4 were found ineligible for MP risk assessment because >3 lymph nodes were found to be malignant. Out of all eligible patients, 14/50 (28%) had samples whose quantity of tumor was not sufficient for analysis (QNS). Out of eligible patients with tumors <1 cm, 7/8 (88%) had QNS samples. 7/42 with tumors ≥1 cm (17%) had QNS samples. Nine patients had discordant receptor results when evaluated by IHC versus. TP. Of patients who also underwent OncotypeDx testing, 6/14 (43%) had discordant results with MP. Conclusions. This study indicates that using MP/TP assay is feasible in a tertiary care center but there may be utility in limiting MP testing to patients with tumors between 1 and 5 cm due to high likelihood of uninformative results in subcentimeter tumors. Further study is needed to explore the discordance between oncotype and MP results.http://dx.doi.org/10.6064/2012/942507
spellingShingle C. Francisco Espinel
Shaughn Keating
Hanina Hibshoosh
Bret Taback
Kathie-Ann Joseph
Mahmoud El-Tamer
Sheldon Feldman
MammaPrint Feasibility in a Large Tertiary Urban Medical Center: An Initial Experience
Scientifica
title MammaPrint Feasibility in a Large Tertiary Urban Medical Center: An Initial Experience
title_full MammaPrint Feasibility in a Large Tertiary Urban Medical Center: An Initial Experience
title_fullStr MammaPrint Feasibility in a Large Tertiary Urban Medical Center: An Initial Experience
title_full_unstemmed MammaPrint Feasibility in a Large Tertiary Urban Medical Center: An Initial Experience
title_short MammaPrint Feasibility in a Large Tertiary Urban Medical Center: An Initial Experience
title_sort mammaprint feasibility in a large tertiary urban medical center an initial experience
url http://dx.doi.org/10.6064/2012/942507
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