Comparative survival analysis of multiparametric tests—when molecular tests disagree—A TEAM Pathology study

Abstract Multiparametric assays for risk stratification are widely used in the management of both node negative and positive hormone receptor invasive breast cancer. Recent data from multiple sources suggests that different tests may provide estimates at individual patient level. The TEAM pathology study consists 3284 postmenopausal ER+ve cancers treated with endocrine therapy Using genes comprising following multi-parametric OncotypeDx ® , Prosigna™ MammaPrint signatures were trained to recapitulate true assay results. Patients then classified into groups survival assessed. Whilst likelihood χ 2 ratios suggested limited value combining tests, Kaplan–Meier LogRank within combinations provided statistically significant potential clinical value. Paradoxically whilst Prosigna-trained results stratified Oncotype-trained subgroups across low intermediate categories, only cases further by Both MammaPrint-trained cases, also but not Comparisons between existing multiparametric challenging, evidence on discordance presents dilemmas. Detailed analysis a complex inter-relationship test same cohorts which requires careful evaluation regarding utility. Further prognostic improvement appears desirable achievable.