Annual hazard rates of recurrence for breast cancer during 24 years of follow-up

Results from the international breast cancer study group trials I to V

Marco Colleoni, Zhuoxin Sun, Karen N. Price, Per Karlsson, John F. Forbes, Beat Thürlimann, Lorenzo Gianni, Monica Castiglione, Richard D. Gelber, Alan S. Coates, Aron Goldhirsch

Research output: Contribution to journalArticle

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Abstract

Purpose: Predicting the pattern of recurrence can aid in the development of targeted surveillance and treatment strategies. We identified patient populations that remain at risk for an event at a median follow-up of 24 years from the diagnosis of operable breast cancer. Patients and Methods: International Breast Cancer Study Group clinical trials I to V randomly assigned 4,105 patients between 1978 and 1985. Annualized hazards were estimated for breast cancer-free interval (primary end point), disease-free survival, and overall survival. Results: For the entire group, the annualized hazard of recurrence was highest during the first 5 years (10.4%), with a peak between years 1 and 2 (15.2%). During the first 5 years, patients with estrogen receptor (ER) - positive disease had a lower annualized hazard compared with those with ERnegative disease (9.9% v 11.5%; P = .01). However, beyond 5 years, patients with ER-positive disease had higher hazards (5 to 10 years: 5.4% v 3.3%; 10 to 15 years: 2.9% v 1.3%; 15 to 20 years: 2.8% v 1.2%; and 20 to 25 years: 1.3% v 1.4%; P <.001). Among patients with ER-positive disease, annualized hazards of recurrence remained elevated and fairly stable beyond 10 years, even for those with no axillary involvement (2.0%, 2.1%, and 1.1% for years 10 to 15, 15 to 20, and 20 to 25, respectively) and for those with one to three positive nodes (3.0%, 3.5%, and 1.5%, respectively). Conclusion: Patients with ER-positive breast cancer maintain a significant recurrence rate during extended follow up. Strategies for follow up and treatments to prevent recurrences may be most efficiently applied and studied in patients with ER-positive disease followed for a long period of time.

Original languageEnglish
Pages (from-to)927-935
Number of pages9
JournalJournal of Clinical Oncology
Volume34
Issue number9
DOIs
Publication statusPublished - Mar 20 2016

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Breast Neoplasms
Recurrence
Estrogen Receptors
Disease-Free Survival
Clinical Trials
Survival
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Annual hazard rates of recurrence for breast cancer during 24 years of follow-up : Results from the international breast cancer study group trials I to V. / Colleoni, Marco; Sun, Zhuoxin; Price, Karen N.; Karlsson, Per; Forbes, John F.; Thürlimann, Beat; Gianni, Lorenzo; Castiglione, Monica; Gelber, Richard D.; Coates, Alan S.; Goldhirsch, Aron.

In: Journal of Clinical Oncology, Vol. 34, No. 9, 20.03.2016, p. 927-935.

Research output: Contribution to journalArticle

Colleoni, Marco ; Sun, Zhuoxin ; Price, Karen N. ; Karlsson, Per ; Forbes, John F. ; Thürlimann, Beat ; Gianni, Lorenzo ; Castiglione, Monica ; Gelber, Richard D. ; Coates, Alan S. ; Goldhirsch, Aron. / Annual hazard rates of recurrence for breast cancer during 24 years of follow-up : Results from the international breast cancer study group trials I to V. In: Journal of Clinical Oncology. 2016 ; Vol. 34, No. 9. pp. 927-935.
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abstract = "Purpose: Predicting the pattern of recurrence can aid in the development of targeted surveillance and treatment strategies. We identified patient populations that remain at risk for an event at a median follow-up of 24 years from the diagnosis of operable breast cancer. Patients and Methods: International Breast Cancer Study Group clinical trials I to V randomly assigned 4,105 patients between 1978 and 1985. Annualized hazards were estimated for breast cancer-free interval (primary end point), disease-free survival, and overall survival. Results: For the entire group, the annualized hazard of recurrence was highest during the first 5 years (10.4{\%}), with a peak between years 1 and 2 (15.2{\%}). During the first 5 years, patients with estrogen receptor (ER) - positive disease had a lower annualized hazard compared with those with ERnegative disease (9.9{\%} v 11.5{\%}; P = .01). However, beyond 5 years, patients with ER-positive disease had higher hazards (5 to 10 years: 5.4{\%} v 3.3{\%}; 10 to 15 years: 2.9{\%} v 1.3{\%}; 15 to 20 years: 2.8{\%} v 1.2{\%}; and 20 to 25 years: 1.3{\%} v 1.4{\%}; P <.001). Among patients with ER-positive disease, annualized hazards of recurrence remained elevated and fairly stable beyond 10 years, even for those with no axillary involvement (2.0{\%}, 2.1{\%}, and 1.1{\%} for years 10 to 15, 15 to 20, and 20 to 25, respectively) and for those with one to three positive nodes (3.0{\%}, 3.5{\%}, and 1.5{\%}, respectively). Conclusion: Patients with ER-positive breast cancer maintain a significant recurrence rate during extended follow up. Strategies for follow up and treatments to prevent recurrences may be most efficiently applied and studied in patients with ER-positive disease followed for a long period of time.",
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AU - Karlsson, Per

AU - Forbes, John F.

AU - Thürlimann, Beat

AU - Gianni, Lorenzo

AU - Castiglione, Monica

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