Some Women at Risk for Recurrences Long After Breast Cancer Therapy

Some women with early breast cancer remain at a substantial risk for developing a cancer recurrence years following therapy. These results were recently published in the Journal of the National Cancer Institute.

Early breast cancer refers to cancer that has not spread to distant sites in the body. Fortunately, following standard therapy for early breast cancer, cure rates remain high. However, a portion of patients with early breast cancer will experience a recurrence several years following therapy. Identification of factors associated with recurrences among these patients will allow for individualized therapeutic choices and/or stricter screening for recurrences.

Researchers from the University of Texas M.D. Anderson Cancer Center recently conducted a clinical study to explore the risks associated with recurrences several years following therapy for women with early breast cancer. The study included 2,838 patients with Stages I-III breast cancer who were treated with systemic (full-body) therapy between 1985 and 2001 and who had no sign of cancer five years following the beginning of their therapy.

At 10 years survival with no recurrences was achieved in 89% of patients, while at 15 years this rate was 80%.
Five years following the completion of therapy, recurrence risks were 7% for patients with Stage I cancer; 11% for patients with Stage II cancer; and 13% for patients with Stage III cancer.
Patients with hormone-positive cancer (estrogen-receptor and/or progesterone-receptor positive) had an increased risk of a recurrence (13% at five years following completion of therapy) compared with those with hormone-negative cancers (7%); this difference was especially true for patients with hormone-positive breast cancer who did not receive endocrine (anti-estrogen) therapy.
This study did not include measures of the human epidermal growth factor receptor 2 (HER2) status or Herceptin® (trastuzumab) and did not include patients treated with aromatase inhibitors, all of which may affect outcomes.

The researchers concluded: “Breast cancer patients have a substantial residual risk of recurrence, and selected tumor characteristics are associated with late recurrences.” Overall, however, the risk of late recurrences remains low for patients with early breast cancer, and improved therapies may affect these outcomes. Nonetheless, it remains important to identify factors that may increase a patient’s risk for a recurrence so that therapy and monitoring may be individualized appropriately.

Reference: Brewster A, Hortobagyi G, Broglio K, et al. Residual risk of breast cancer recurrence 5 years after adjuvant therapy. Journal of the National Cancer Institute [early online publication]. August 11, 2008. DOI: 10.1093/jnci/djn233.

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