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BC Recurrence Risk Post-Endocrine Therapy Assessed
N Engl J Med; 2017 Nov 9; Pan, Gray, et al
Risk of distant recurrence of breast cancer is strongly related with original nodal status, researchers concluded after conducting a meta-analysis of 88 trials involving nearly 63,000 women. Participants had estrogen-receptor-positive breast cancer and were disease-free after 5 years of endocrine therapy. Among the findings:
- In patients with stage T1 disease, distant recurrence risk was 13% with no nodal involvement (T1N0); 20% with 1 to 3 involved nodes; and 34% with 4 to 9 involved nodes.
- In those with stage T2 disease, recurrence risks were 19%, 26%, and 41%, respectively.
- Breast cancer death risk was also TN status-dependent; contralateral breast cancer development was not.
- Tumor grade and Ki-67 status had moderate independent predictive value.
- Progesterone receptor and HER2 statuses were not predictive.
- The absolute risk of distant recurrence among patients with T1N0 breast cancer was 10% for low-grade, 13% for moderate-grade, and 17% for high-grade disease.
- Risks of any recurrence or a contralateral breast cancer were 17%, 22%, and 26%, respectively.
Citation:
Pan H, Gray R, Braybrooke j, et al. 20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years. N Engl J Med. 2017;377:1836-1846. doi:10.1056/NEJMoa1701830.