What can predict cancer recurrence in node-negative patients?

This study investigated which traits of low-risk breast cancer can predict the risk of cancer recurrence after treatments.

The majority of women who are diagnosed with breast cancer have node-negative cancer, meaning breast cancer that has not spread to regional lymph nodes. Node-negative breast cancer patients have a low likelihood of cancer recurrence, and are often referred to as low-risk cancer patients. However, some of these patients will experience recurrence. Therefore, it is important to identify breast cancer traits that may predict the risk of recurrence, and treat this subgroup. Some factors that have been suggested as predictors of recurrence are lymphovascular invasion (LVI; growth of the cancer into nearby blood or lymph vessels) and tumor grade (determined by the appearance of the cancer cells under a microscope; abnormal features represent more aggressive potential of the tumor and have higher grades, scored 1-3).

Researchers followed 716 node-negative breast cancer patients whose tumors were surgically removed. 47 patients (6.6%) experienced cancer recurrence during an average follow-up period of 4 years.

Patients with LVI were 4 times more likely to experience cancer recurrence compared to patients without evidence of LVI. Patients with grade 3 tumors were 5 times more likely to experience recurrence compared to patients with low grade tumors. Radiotherapy following surgery was found to eliminate this elevated risk of recurrence for both patients with LVI and grade 3 tumors. Chemotherapy following surgery, however, was not found to reduce this elevated risk.

This study concluded that both lymphovascular invasion and high tumor grade are associated with increased risk of recurrence among node-negative breast cancer patients. In such patients, radiotherapy given after surgery may delay or prevent recurrence.