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Divisions of 1 Experimental Therapy and 2 Diagnostic Oncology, The Netherlands Cancer Institute; 3 Agendia B.V., Amsterdam, the Netherlands; 4 Lineberger Comprehensive Cancer Center; and Departments of 5 Genetics, 6 Pathology and Laboratory Medicine, and 7 Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
Requests for reprints: Laura J. van't Veer, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands. Phone: 31-20-512-2754; Fax: 31-20-512-2759; E-mail: l.vt.veer{at}nki.nl.
Microarray analysis has been shown to improve risk stratification of breast cancer. Breast tumors analyzed by hierarchical clustering of expression patterns of "intrinsic" genes have been reported to subdivide into at least four molecular subtypes that are associated with distinct patient outcomes. Using a supervised method, a 70-gene expression profile has been identified that predicts the later appearance or absence of clinical metastasis in young breast cancer patients. Here, we show that distant metastases display both the same molecular breast cancer subtype as well as the 70-gene prognosis signature as their primary tumors. Our results suggest that the capacity to metastasize is an inherent feature of most breast cancers. Furthermore, our data imply that poor prognosis breast carcinomas classified either by the intrinsic gene set or the 70 prognosis genes represent distinct disease entities that seem sustained throughout the metastatic process.
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