About 1 in 5 breast cancer survivors who have completed 5 years of adjuvant systemic therapy (AST) suffer a recurrence within the 10 years after their treatment, according to a 2008 study published in the Journal of the National Cancer Institute.
Context and Caveats
Prior knowledge:
Adjuvant and neoadjuvant systemic therapy (AST) improves the survival of breast cancer patients, but there is still a risk that the disease will recur years later.
Study design:
Disease recurrence among breast cancer patients who were disease free 5 years after AST (the landmark) was estimated 5 and 10 years after landmark. Multivariable analysis was used to identify factors associated with recurrence.
Contributions:
Rates of recurrence-free survival at 5 years and 10 years after landmark were 89% and 80%, respectively. The risk of recurrence 5 years after therapy increased with tumor stage (stage 1: 7%, stage II: 11%, and stage 3: 13%) and was also associated with tumor grade, hormone receptor status, and endocrine therapy.
Implications:
Breast cancer patients who undergo AST are at risk of late recurrences, and this risk is associated with certain characteristics of the original tumor.
Limitations:
HER2/neu status was not included in the analysis because the data were not available; aromatase inhibitor treatment was not included because too few women received it.
Sources and full study:
Residual Risk of Breast Cancer Recurrence 5 Years After Adjuvant Therapy, JNCI, June 2008, Vol 100, Issue 16Pp. 1179-1183.
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