Background

The aim of this article was to evaluate the prognostic value of the MammaPrintTM signature in women $$ 60 years with invasive breast cancer.

Patients and Methods

60 female patients were included in this prospective study. Eligibility criteria included: pT1c-3, pN0–1a, grade 2/3, hormone receptor-positive and HER2-negative tumor. The clinical risk was determined by Adjuvant! Online (AOL).

Results

38 patients (63%) where considered to be low-risk patients by the 70-gene signature, while 22 (37%) were considered to be high-risk patients. No statistically significant differences between low- and high-risk groups could be detected for conventional prognostic parameters, particularly not for Ki-67. By AOL, 33 patients (55%) were considered to be at high risk, of which 20 had a discordant MammaPrintTM result. The discordance rate between the profile and AOL was 48%, which is higher than in previous publications. When the 70-gene signature was used in combination with the clinical risk assessment, the recommendation for adjuvant systemic treatment differed in 11 patients (18%).

Conclusions

In the intermediate-risk subgroup, the 70-gene signature could be useful to decide in elderly patients whether they may benefit from adjuvant chemotherapy or not. Conventional clinicopathological factors were not suitable for a prediction of the 70-gene signature results in these patients.

Summary

A German working group of 23 breast cancer experts discussed the results from the vote at this year's St. Gallen Consensus Conference on Primary Therapy for Early Breast Cancer (March 11–14, 2009) and came up with some concrete recommendations for day-to-day therapeutic decisions in Germany. Due the fact that the concept of the St. Gallen Consensus Conference merely allows for a minimal consensus, the objective of the working group was to provide practice-related recommendations for day-to-day clinical decisions in Germany. One area of emphasis at St. Gallen was tumor biology as a starting point for reaching individual therapeutic decisions. Intensive discussion was necessary with respect to the clinical relevance of predictive and prognostic factors. A new addition to the area of systemic therapy was a first-ever discussion of the adjuvant administration of bisphosponates and the fact that therapy with trastuzumab in HER2 overexpressing breast cancer has been defined as the standard for neoadjuvant therapy. The value of taxanes as a component of (neo)adjuvant chemotherapy as well as the value of aromatase inhibitors for the endocrine adjuvant treatment of postmenopausal patients were affirmed.

Summary

Isoflavones are plant-derived substances with weak es-trogenic effects. Asian populations are high consumers of soy products which are rich in isoflavones. The lower breast cancer incidence in Asian women compared with Western women has been associated with the possibility of a preventive isoflavone effect on cancer risk. The aim of this review is to give an overview of current research data on the influence of isoflavones on the risk of primary breast cancer development as well as the risk of recurrence in breast cancer patients. Despite inconsistencies in the available data, an inverse correlation between isoflavone intake and risk of breast cancer is likely. However, a negative impact on breast cancer disease, especially on hormone receptor-positive tumors, cannot be excluded at present.