Reassessing estrogen receptor expression thresholds for breast cancer prognosis in HER2-negative patients using shape restricted modeling.

ABSTRACT: We used a novel shape-restricted Cox model to determine the desirable ER expression cutoff to predict breast cancer prognoses. Our model treats ER as a continuous variable using a flexible monotone-shaped Cox regression to assess its association with survival outcomes holistically. The study included 3055 patients with stage II/III HER2-negative breast cancer. The primary outcomes were time to recurrence or death (TTR) and overall survival (OS). The shape-restricted Cox model identified 10% ER as the preferred cutoff to predict TTR. The finding was confirmed by the log-rank test and standard Cox model that patients with ER ≥ 10% had TTR benefit over ER < 10% (log-rank p < 0.001). No OS or TTR benefit of adjuvant endocrine therapy was observed in patients with 1% ≤ ER < 10% (HR 0.877, 95% C

SUBMITTER: Dong W 

PROVIDER: S-EPMC11829975 | biostudies-literature | 2025 Feb

REPOSITORIES: biostudies-literature