Strand et al reported the CAGE model for evaluating a woman with breast cancer. This help to separate a low risk patient from a patient who may benefit from more aggressive management. The authors are from Lund University, University Hospital Orebro, Uppsala University and Skane University in Sweden.
Patient selection: premenopausal woman with breast cancer and negative lymph nodes
Parameters:
(1) cyclin A (CA) immunoreactivity
(2) histologic grade (G), 1 (well-differentiated) to 3 (poorly differentiated)
(3) ER status (E)
Cyclin A immunoreactivity was high if the number of positive cells was >= 15%.
Cyclin A
Histologic Grade
ER Status
Risk
NA
Grade 1
NA
low
low
Grade 2
positive
low
high
Grade 2
positive
high
NA
Grade 2
negative
high
NA
Grade 3
NA
high
The 5-year distant disease-free survival was 95% in the low-risk group.
The 5-year distant disease-free survival was 73% in the high-risk group.
HER2 status also impacted outcome, with a positive status having a hazard ratio of 4.1.
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