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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Breast Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1517073
Additional prognostic value of the BCT score in ER+HER2-breast cancer patients receiving a 21-gene assay-guided adjuvant treatments
Provisionally accepted
Sung Gwe Ahn 1,2
Jonghan Yu 3 Seung Ho Baek 1,2
Yeonjin Kim 3 Woo Young Kim 4
Jai Hyun Chung 4
Soong June Bae 1,2
Seok Won Kim 3 Seok Jin Nam 3
Gyungyub Gong 5
Young-Won Lee 5
Jaihong Han 6
Joon Jeong 1,2 Sang Uk Woo 4
Eun-Gyeong Lee 6*
Sae Byul Lee 7*- 1 Gangnam Severance Hospital, Seoul, Seoul, Republic of Korea
- 2 Institue for Breast Cancer Precision Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- 3 Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
- 4 Korea University Guro Hospital, Seoul, Republic of Korea
- 5 Asan Medical Center, College of Medicine, University of Ulsan, SONGPA-GU, Seoul, Republic of Korea
- 6 National Cancer Center, Goyang-si, Republic of Korea
- 7 Surgery, Asan Medical Center, College of Medicine, University of Ulsan, SONGPA-GU, Republic of Korea
The 21-gene recurrence score (RS)-guided decision-making for adjuvant treatment has been utilized as a standard of care for early ER+HER2-breast cancer. We investigated a prognostic value of the Breast Cancer Test (BCT) score, a multigene assay incorporating clinical risk, in estrogen receptor (ER)+HER2-breast cancer patients receiving RS-guided adjuvant treatments, specifically focusing on chemotherapy-untreated patients with low RS.Methods: This multicenter cohort study included 759 patients who received RS-guided adjuvant treatment. The primary endpoint was recurrence-free survival (RFS), and the secondary endpoint was distant recurrence-free survival (DRFS).Results: At a median follow up of 85 months, the 7-year RFS was 92.9% (95% CI, 90.9%-94.9%). Among the 592 chemotherapy-untreated patients with low RS, the RFS differed significantly according to the BCT score (P=.014); the 7-year RFS was 95.5% (95% CI, 93.4%-97.7%) in the BCT-low group, while it was 89.9% (95% CI, 84.9%-95.1%) in the BCT-high group. The BCT score was an independent prognostic factor for both RFS and DRFS. In addition, the RFS of the low-BCT score group was superior to that of the high-BCT group in women aged 50 years or younger, with an RS of 16 to 25.Our study suggests the utility of the BCT score in stratifying the relapse risk among chemotherapy-untreated patients with a low RS, particularly in young women with an RS of 16-25 who are at risk for long-term recurrence.
Keywords: Breast neoplasm, estrogen receptor, Endocrine therapy, 21-gene recurrence score, BCT score, Prognostic factor
Received: 25 Oct 2024; Accepted: 18 Mar 2025.
Copyright: © 2025 Ahn, Yu, Baek, Kim, Kim, Chung, Bae, Kim, Nam, Gong, Lee, Han, Jeong, Woo, Lee and Lee. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Eun-Gyeong Lee, National Cancer Center, Goyang-si, Republic of Korea
Sae Byul Lee, Surgery, Asan Medical Center, College of Medicine, University of Ulsan, SONGPA-GU, Republic of Korea
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