Journal of the National Cancer Institute Advance Access originally published online on August 11, 2008
JNCI Journal of the National Cancer Institute 2008 100(16):1179-1183; doi:10.1093/jnci/djn233
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© The Author 2008. Published by Oxford University Press.
Residual Risk of Breast Cancer Recurrence 5 Years After Adjuvant Therapy
Affiliations of authors: Departments of Clinical Cancer Prevention (AMB), Breast Medical Oncology (GNH, S-WK, CAS-M, BA, AUB, DJB, VV, FJE), Division of Quantitative Sciences (KRB), Department of Epidemiology (MB), The University of Texas M.D. Anderson Cancer Center, Houston, TX
Correspondence to: Abenaa M. Brewster, MD, MHS, PO Box 301439, Houston, TX 77230-1439 (e-mail: abrewster{at}mdanderson.org).
There is limited prognostic information to identify breast cancer patients who are at risk for late recurrences after adjuvant or neoadjuvant systemic therapy (AST). We evaluated the residual risk of recurrence and prognostic factors of 2838 patients with stage I–III breast cancer who were treated with AST between January 1, 1985, and November 1, 2001, and remained disease free for 5 years. Residual recurrence-free survival was estimated from the landmark of 5 years after AST to date of first recurrence or last follow-up using the Kaplan–Meier method. The log-rank test (two-sided) was used to compare groups. Residual recurrence-free survival rates at 5 and 10 years were 89% and 80%, respectively, and 216 patients developed a recurrence event. The 5-year residual risks of recurrence for patients with stage I, II, and III cancers were 7% (95% confidence interval [CI] = 3% to 15%), 11% (95% CI = 9% to 13%), and 13% (95% CI = 10% to 17%), respectively (P = .02). In multivariable analysis, stage, grade, hormone receptor status, and endocrine therapy were associated with late recurrences. Breast cancer patients have a substantial residual risk of recurrence, and selected tumor characteristics are associated with late recurrences.
| CONTEXT AND CAVEATS Prior knowledge Adjuvant and neoadjuvant systemic therapy (AST) improves the survival of breast cancer patients, but there is still a risk that the disease will recur years later. Study design Disease recurrence among breast cancer patients who were disease free 5 years after AST (the landmark) was estimated 5 and 10 years after landmark. Multivariable analysis was used to identify factors associated with recurrence. Contributions Rates of recurrence-free survival at 5 years and 10 years after landmark were 89% and 80%, respectively. The risk of recurrence 5 years after therapy increased with tumor stage (stage 1: 7%, stage II: 11%, and stage 3: 13%) and was also associated with tumor grade, hormone receptor status, and endocrine therapy. Implications Breast cancer patients who undergo AST are at risk of late recurrences, and this risk is associated with certain characteristics of the original tumor. Limitations HER2/neu status was not included in the analysis because the data were not available; aromatase inhibitor treatment was not included because too few women received it. From the Editors
|
Manuscript received January 4, 2008; revised May 19, 2008; accepted June 11, 2008.
CiteULike 
Connotea 
Del.icio.us What's this?
Find additional patient-related information at:
Related Articles in JNCI
-
IN THIS ISSUE
J Natl Cancer Inst 2008 100: 1119.[Extract] [Full Text] [PDF]
-
Breast Cancer Patients Still Have Risk of Relapse After Five Years of Systemic Therapy
J Natl Cancer Inst 2008 100: 1119.[Extract] [Full Text] [PDF]
This article has been cited by other articles:
|
|
 |
|
  J. L.F. Bosco, T. L. Lash, M. N. Prout, D. S.M. Buist, A. M. Geiger, R. Haque, F. Wei, R. A. Silliman, and for the BOW Investigators Breast Cancer Recurrence in Older Women Five to Ten Years after Diagnosis Cancer Epidemiol. Biomarkers Prev., November 1, 2009; 18(11): 2979 - 2983. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Beslija, J. Bonneterre, H. J. Burstein, V. Cocquyt, M. Gnant, V. Heinemann, J. Jassem, W. J. Kostler, M. Krainer, S. Menard, et al. Third consensus on medical treatment of metastatic breast cancer Ann. Onc., November 1, 2009; 20(11): 1771 - 1785. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Natarajan, M. Pu, B. A. Parker, C. A. Thomson, B. J. Caan, S. W. Flatt, L. Madlensky, R. A. Hajek, W. K. Al-Delaimy, N. Saquib, et al. Time-Varying Effects of Prognostic Factors Associated With Disease-Free Survival in Breast Cancer Am. J. Epidemiol., June 15, 2009; 169(12): 1463 - 1470. [Abstract] [Full Text] [PDF]
|
|