Conditional local recurrence risk: the effect of event-free years in different subtypes of breast cancer.

Autor: Moossdorff M; Department of Surgical Oncology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.; GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands., Vane MLG; Department of Surgical Oncology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. marissa.vane@gmail.nl.; GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands. marissa.vane@gmail.nl., van Nijnatten TJA; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands., van Maaren MC; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.; Department of Health, Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands., Goorts B; Department of Surgical Oncology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.; GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands., Heuts EM; Department of Surgical Oncology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.; GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands., Strobbe LJA; Department of Surgical Oncology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands., Smidt ML; Department of Surgical Oncology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.; GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2021 Apr; Vol. 186 (3), pp. 863-870. Date of Electronic Publication: 2021 Mar 10.
DOI: 10.1007/s10549-020-06040-3
Abstrakt: Background: After breast cancer treatment, follow-up consists of physical examination and mammography for at least 5 years, to detect local and regional recurrence. The risk of recurrence may decrease after event-free time. This study aims to determine the risk of local recurrence (LR) as a first event until 5 years after diagnosis, conditional on being event-free for 1, 2, 3 and 4 years.
Methods: From the Netherlands Cancer Registry, all M0 breast cancers diagnosed between 2005 and 2008 were included. LR risk was calculated with Kaplan-Meier analysis, overall and for different subtypes. Conditional LR (assuming x event-free years) was determined by selecting event-free patients at x years, and calculating their LR risk within 5 years after diagnosis.
Results: Five-year follow-up was available for 34,453 patients. Overall, five-year LR as a first event occurred in 3.0%. This risk varied for different subtypes and was highest for triple negative (6.8%) and lowest for ER+PR+Her2- (2.2%) tumors. After 1, 2, 3 and 4 event-free years, the average risk of LR before 5 years after diagnosis decreased from 3.0 to 2.4, 1.6, 1.0, and 0.6%. The risk decreased in all subtypes, the effect was most pronounced in subtypes with the highest baseline risk (ER-Her2+ and triple negative breast cancer). After three event-free years, LR risk in the next 2 years was 1% or less in all subtypes except triple negative (1.6%).
Conclusion: The risk of 5-year LR as a first event was low and decreased with the number of event-free years. After three event-free years, the overall risk was 1%. This is reassuring to patients and also suggests that follow-up beyond 3 years may produce low yield of LR, both for individual patients and studies using LR as primary outcome. This can be used as a starting point to tailor follow-up to individual needs.
Databáze: MEDLINE
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