The Magee Equation: A Potential Economic Alternative in the Prognostication of Patients With Breast Cancer

麦基方程:乳腺癌患者预后预测中一种潜在的经济替代方法

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Abstract

INTRODUCTION: Breast cancer is a heterogeneous disease classified by histopathological and molecular features. While the Oncotype DX assay is widely used to predict prognosis in estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative cases, its high cost limits accessibility. The Magee equations, derived from immunohistochemical and clinicopathological variables, offer a cost-effective alternative for recurrence risk estimation. The Clinical Treatment Score at 5 years (CTS5) model further aids in predicting late distant recurrence using routine clinical parameters. AIM AND OBJECTIVES: To derive the Magee Equation 3 (ME3) and CTS5 scores in each patient and categorize them into prognostic groups. To compare the ME3 score with the CTS5 score and observe the treatment response/recurrence rate in the study population. To hypothesize the validity and utility of the ME3 score as a cheaper alternative to more expensive genetic tests. MATERIALS AND METHODS: A cross-sectional study of 50 consecutive cases of primary breast cancer, which are ER/progesterone receptor (PR) positive, has been included in the study. The CTS5 and ME3 recurrence score (RS) were calculated using the online websites https://cts5-calculator.com and https://path.upmc.edu/onlineTools/mageeequations.html, respectively. The results were tabulated. The follow-up records of patients were reviewed. RESULTS: A total of 50 cases of breast carcinoma were included. The number of cases in low-, intermediate-, and high-risk categories of the CTS5 score was 26 cases (52%), 19 cases (36%), and five cases (10%), respectively. The number of cases in low-, intermediate-, and high-risk categories of ME3 RS was two cases (4%), 31 cases (62%), and 17 cases (34%), respectively. A high level of concordance between ME3 RS and CTS5 scores was observed in the intermediate category (20%; n = 10). CONCLUSION:  The Magee Equation 3 (ME3) is a reliable, simple, and cost-effective tool that correlates well with the CTS5 model, making it a practical alternative for predicting recurrence risk and guiding treatment decisions in breast cancer.

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