breast cancer
Research
Source: World Journal of Surgery
Indicators of the time until highest recurrence risk
In a nutshell
This study assessed which among the known indicators of breast cancer recurrence can most accurately predict the time of breast cancer return.
Some background
Breast cancer can recur at any time, but most recurrences occur in the first three to five years after treatment. Several tumor and patient characteristics may help predict the risk and timing of possible breast cancer recurrence. These indicators include tumor size, tumor grade (as determined by the appearance of the tumor cells under a microscope), lymph node involvement, estrogen and progesterone receptor status, patient age and menopausal status. Although these indicators have been extensively investigated as predictors of the risk of cancer recurrence, whether these predictors could be used to indicate the timing of recurrence has not yet been examined.
Methods & findings
The study involved 473 patients with recurrent breast cancer. Medical records were analyzed to determine which factors most accurately correlate with the time of breast cancer recurrence.
Tumor grade was found to most accurately predict breast cancer recurrence time. Among patients with low-grade breast tumors, the average time until cancer recurrence was 5 years. In comparison, the average time before recurrence for patients with medium grade breast tumors was 3.8 years, and was 2 years among patients with high-grade breast cancer tumors. Original tumor size was also found to correlate with the time until recurrence. Both estrogen and progesterone receptor status were determined to influence the time of cancer recurrence as well. Estrogen or progesterone receptor negativity correlated with significantly earlier recurrences.
Surprisingly, lymph node involvement, menopausal status and patient age did not show any correlation with the time of breast cancer recurrence.
The bottom line
This study identified tumor grade, tumor size and hormone receptor status as the best predictors of time until breast cancer recurrence.
Disclaimer:
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I had HER 2 positive reast cancer which has spread to my limf nodes. My tumor was a grade 9 on the Nottingham scale. I am currently in remission. So does that place me at the highest risk for recurence and what is my risk? Reply
The study is about time to recurrence, not about the risk of recurrence.
I fear that unless this study is more carefully explained, the women who read it will worry without cause.
I'm also HER2+, high grade, with nodal involvement. I'm also more than 3 years out with no sign of recurrence. It will happen or it won't; no sense living in fear for as long as I'm cancer-free. Reply
Hi ladies, thanks for your input and your questions! Marietje, Rhonda is correct; the study is assessing whether particular cancer characteristics are associated with time to recurrence, not risk of recurrence. In the study, those with high grade tumors who relapsed were more likely to present with recurrences by 5 years (88% of patients had recurred by 5 years and 99% by 8 years) than those with low grade tumors (55% of recurrences occurred within 5 years). That is not to say that 88% of patients with high grade tumors WILL recur by 5 or 8 years; it simply means that IF recurrence occurs, it is most likely to happen by these time points. The average time to recurrence with high grade tumors was 2 years. Again, this does not imply that you WILL recur at 2 years, as highlighted by the great fact that Rhonda is recurrence-free for more than 3 years; it simply highlights that the risk of recurrence is higher within these 2 years. I hope this answered your questions! Reply
Hi Rhonda when refering to the grade of the tumor are you referring to the Nottingham scale?And is the estimated recurrence time measured from the time of diagnosis or from after the chemo treatment? Reply
Hi Marietjie, the estimated recurrence time was from the time of diagnosis. Reply
Thank you :)
Reply
Does the study correct for pathological complete response to neoadjuvant chemo? Reply
No, it does not.
The paper is available at DeepDyve for free for a 5-minute view or for 1 token for a 30-day rental. Tokens are purchased in packs of 5 for $20, and you can use the remaining tokens as the need arises. For this paper, all I needed was the five-minute view to see that chemotherapy was not mentioned at all.
Many other papers are available at low and no-cost through patient-access programs. Each journal publisher provides a different method, and sometimes you have to search for them. This one was relatively easy. Reply