Year-end Sale % OFF 
Abstract
Residual risk of relapse remains a substantial concern for patients with hormone receptor-positive breast cancer, with approximately half of all disease recurrences occurring after five years of adjuvant antiestrogen therapy. The objective of this study was to examine the prognostic performance of an optimized model of Breast Cancer Index (BCI), an algorithmic gene expression-based signature, for prediction of early (0-5 years) and late (>5 years) risk of distant recurrence in patients with estrogen receptor-positive (ER(+)), lymph node-negative (LN(-)) tumors. The BCI model was validated by retrospective analyses of tumor samples from tamoxifen-treated patients from a randomized prospective trial (Stockholm TAM, n = 317) and a multi-institutional cohort (n = 358). Within the Stockholm TAM cohort, BCI risk groups stratified the majority (∼65%) of patients as low risk with less than 3% distant recurrence rate for 0 to 5 years and 5 to 10 years. In the multi-institutional cohort, which had larger tumors, 55% of patients were classified as BCI low risk with less than 5% distant recurrence rate for 0 to 5 years and 5 to 10 years. For both cohorts, continuous BCI was the most significant prognostic factor beyond standard clinicopathologic factors for 0 to 5 years and more than five years. The prognostic sustainability of BCI to assess early- and late-distant recurrence risk at diagnosis has clinical use for decisions of chemotherapy at diagnosis and for decisions for extended adjuvant endocrine therapy beyond five years.
Highlights
Breast cancer is a heterogeneous disease with a significant proportion of patients with breast cancer diagnosed with estrogen receptor–positive (ERþ) tumors with lymph node– negative (LNÀ) status at diagnosis [1]
In the multi-institutional cohort, which had larger tumors, 55% of patients were classified as Breast Cancer Index (BCI) low risk with less than 5% distant recurrence rate for 0 to 5 years and 5 to 10 years
Comprehensive assessment of risk of recurrence for ERþ LNÀ patients with a time horizon that spans from diagnosis to 10 years would be clinically useful for identifying both patients with sustained low risk of recurrence for avoidance of chemotherapy and those with high risk of recurrence beyond 5 years for the decision of whether to extend adjuvant endocrine therapy
Summary
Breast cancer is a heterogeneous disease with a significant proportion of patients with breast cancer diagnosed with estrogen receptor–positive (ERþ) tumors with lymph node– negative (LNÀ) status at diagnosis [1]. Compared with other clinical subgroups, ERþ LNÀ patients have the best overall prognosis. The rate of recurrence for ERþ LNÀ patients surpasses those of other clinical subgroups [triplenegative and HER2–positive (HER2þ)] for patients that remain disease-free for 5 years [2]. Comprehensive assessment of risk of recurrence for ERþ LNÀ patients with a time horizon that spans from diagnosis to 10 years would be clinically useful for identifying both patients with sustained low risk of recurrence for avoidance of chemotherapy and those with high risk of recurrence beyond 5 years for the decision of whether to extend adjuvant endocrine therapy. Given the persistent risk of recurrence beyond 5 years, there is a significant clinical unmet need for biomarkers that accurately assess the risk of recurrence across the full disease time horizon
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
