Risk factors for locoregional recurrence among breast cancer patients: Results from International Breast Cancer Study Group Trials I through VII

Arne Wallgren, M. Bonetti, R. D. Gelber, A. Goldhirsch, M. Castiglione-Gertsch, S. B. Holmberg, J. Lindtner, B. Thürlimann, M. Fey, I. D. Werner, J. F. Forbes, K. Price, A. S. Coates, J. Collins

Research output: Contribution to journalArticle

Abstract

Purpose: To explore prognostic factors for locoregional failures (LRF) among women treated for invasive breast cancer within clinical trials of adjuvant therapies. Patients and Methods: The study population consisted of 5,352 women who were treated with a modified radical mastectomy and enrolled in one of seven International Breast Cancer Study Group randomized trials. A total of 1,275 women with node-negative disease received either no adjuvant therapy or a single cycle of perioperative chemotherapy, and 4,077 women with node-positive disease received adjuvant chemotherapy of at least 3 months' duration and/or tamoxifen. Median follow-up is 12 to 15.5 years. Results: In women with node-negative disease, factors associated with increased risk of LRF were vascular invasion (VI) and tumor size greater than 2 cm for premenopausal and VI for postmenopausal patients. Of the 1,275 patients, 345 (27%) met criteria for the highest risk groups, and the 10-year cumulative incidences of LRF with or without distant metastases were 16% for premenopausal and 19% for postmenopausal women. For the node-positive cohort, number of nodes and tumor grade were factors for both menopausal groups, with additional prediction provided by VI for premenopausal and tumor size for postmenopausal patients. Of the 4,077 patients, 815 (20%) met criteria for the highest risk groups, and 10-year cumulative incidences were 35% for premenopausal and 34% for postmenopausal women. Conclusion: LRFs are a significant problem after mastectomy alone even for some patients with node-negative breast cancer, as well as after mastectomy and adjuvant treatment for some subgroups of patients with node-positive disease. In addition to number of positive lymph nodes, predictors of LRF include tumor-related factors, such as vascular invasion, higher grade, and larger size.

Original languageEnglish
Pages (from-to)1205-1213
Number of pages9
JournalJournal of Clinical Oncology
Volume21
Issue number7
DOIs
Publication statusPublished - Apr 1 2003

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Breast Neoplasms
Recurrence
Blood Vessels
Mastectomy
Neoplasms
Modified Radical Mastectomy
Incidence
Tamoxifen
Adjuvant Chemotherapy
Therapeutics
Lymph Nodes
Clinical Trials
Neoplasm Metastasis
Drug Therapy
Population

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Risk factors for locoregional recurrence among breast cancer patients : Results from International Breast Cancer Study Group Trials I through VII. / Wallgren, Arne; Bonetti, M.; Gelber, R. D.; Goldhirsch, A.; Castiglione-Gertsch, M.; Holmberg, S. B.; Lindtner, J.; Thürlimann, B.; Fey, M.; Werner, I. D.; Forbes, J. F.; Price, K.; Coates, A. S.; Collins, J.

In: Journal of Clinical Oncology, Vol. 21, No. 7, 01.04.2003, p. 1205-1213.

Research output: Contribution to journalArticle

Wallgren, A, Bonetti, M, Gelber, RD, Goldhirsch, A, Castiglione-Gertsch, M, Holmberg, SB, Lindtner, J, Thürlimann, B, Fey, M, Werner, ID, Forbes, JF, Price, K, Coates, AS & Collins, J 2003, 'Risk factors for locoregional recurrence among breast cancer patients: Results from International Breast Cancer Study Group Trials I through VII', Journal of Clinical Oncology, vol. 21, no. 7, pp. 1205-1213. https://doi.org/10.1200/JCO.2003.03.130
Wallgren, Arne ; Bonetti, M. ; Gelber, R. D. ; Goldhirsch, A. ; Castiglione-Gertsch, M. ; Holmberg, S. B. ; Lindtner, J. ; Thürlimann, B. ; Fey, M. ; Werner, I. D. ; Forbes, J. F. ; Price, K. ; Coates, A. S. ; Collins, J. / Risk factors for locoregional recurrence among breast cancer patients : Results from International Breast Cancer Study Group Trials I through VII. In: Journal of Clinical Oncology. 2003 ; Vol. 21, No. 7. pp. 1205-1213.
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abstract = "Purpose: To explore prognostic factors for locoregional failures (LRF) among women treated for invasive breast cancer within clinical trials of adjuvant therapies. Patients and Methods: The study population consisted of 5,352 women who were treated with a modified radical mastectomy and enrolled in one of seven International Breast Cancer Study Group randomized trials. A total of 1,275 women with node-negative disease received either no adjuvant therapy or a single cycle of perioperative chemotherapy, and 4,077 women with node-positive disease received adjuvant chemotherapy of at least 3 months' duration and/or tamoxifen. Median follow-up is 12 to 15.5 years. Results: In women with node-negative disease, factors associated with increased risk of LRF were vascular invasion (VI) and tumor size greater than 2 cm for premenopausal and VI for postmenopausal patients. Of the 1,275 patients, 345 (27{\%}) met criteria for the highest risk groups, and the 10-year cumulative incidences of LRF with or without distant metastases were 16{\%} for premenopausal and 19{\%} for postmenopausal women. For the node-positive cohort, number of nodes and tumor grade were factors for both menopausal groups, with additional prediction provided by VI for premenopausal and tumor size for postmenopausal patients. Of the 4,077 patients, 815 (20{\%}) met criteria for the highest risk groups, and 10-year cumulative incidences were 35{\%} for premenopausal and 34{\%} for postmenopausal women. Conclusion: LRFs are a significant problem after mastectomy alone even for some patients with node-negative breast cancer, as well as after mastectomy and adjuvant treatment for some subgroups of patients with node-positive disease. In addition to number of positive lymph nodes, predictors of LRF include tumor-related factors, such as vascular invasion, higher grade, and larger size.",
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T1 - Risk factors for locoregional recurrence among breast cancer patients

T2 - Results from International Breast Cancer Study Group Trials I through VII

AU - Wallgren, Arne

AU - Bonetti, M.

AU - Gelber, R. D.

AU - Goldhirsch, A.

AU - Castiglione-Gertsch, M.

AU - Holmberg, S. B.

AU - Lindtner, J.

AU - Thürlimann, B.

AU - Fey, M.

AU - Werner, I. D.

AU - Forbes, J. F.

AU - Price, K.

AU - Coates, A. S.

AU - Collins, J.

PY - 2003/4/1

Y1 - 2003/4/1

N2 - Purpose: To explore prognostic factors for locoregional failures (LRF) among women treated for invasive breast cancer within clinical trials of adjuvant therapies. Patients and Methods: The study population consisted of 5,352 women who were treated with a modified radical mastectomy and enrolled in one of seven International Breast Cancer Study Group randomized trials. A total of 1,275 women with node-negative disease received either no adjuvant therapy or a single cycle of perioperative chemotherapy, and 4,077 women with node-positive disease received adjuvant chemotherapy of at least 3 months' duration and/or tamoxifen. Median follow-up is 12 to 15.5 years. Results: In women with node-negative disease, factors associated with increased risk of LRF were vascular invasion (VI) and tumor size greater than 2 cm for premenopausal and VI for postmenopausal patients. Of the 1,275 patients, 345 (27%) met criteria for the highest risk groups, and the 10-year cumulative incidences of LRF with or without distant metastases were 16% for premenopausal and 19% for postmenopausal women. For the node-positive cohort, number of nodes and tumor grade were factors for both menopausal groups, with additional prediction provided by VI for premenopausal and tumor size for postmenopausal patients. Of the 4,077 patients, 815 (20%) met criteria for the highest risk groups, and 10-year cumulative incidences were 35% for premenopausal and 34% for postmenopausal women. Conclusion: LRFs are a significant problem after mastectomy alone even for some patients with node-negative breast cancer, as well as after mastectomy and adjuvant treatment for some subgroups of patients with node-positive disease. In addition to number of positive lymph nodes, predictors of LRF include tumor-related factors, such as vascular invasion, higher grade, and larger size.

AB - Purpose: To explore prognostic factors for locoregional failures (LRF) among women treated for invasive breast cancer within clinical trials of adjuvant therapies. Patients and Methods: The study population consisted of 5,352 women who were treated with a modified radical mastectomy and enrolled in one of seven International Breast Cancer Study Group randomized trials. A total of 1,275 women with node-negative disease received either no adjuvant therapy or a single cycle of perioperative chemotherapy, and 4,077 women with node-positive disease received adjuvant chemotherapy of at least 3 months' duration and/or tamoxifen. Median follow-up is 12 to 15.5 years. Results: In women with node-negative disease, factors associated with increased risk of LRF were vascular invasion (VI) and tumor size greater than 2 cm for premenopausal and VI for postmenopausal patients. Of the 1,275 patients, 345 (27%) met criteria for the highest risk groups, and the 10-year cumulative incidences of LRF with or without distant metastases were 16% for premenopausal and 19% for postmenopausal women. For the node-positive cohort, number of nodes and tumor grade were factors for both menopausal groups, with additional prediction provided by VI for premenopausal and tumor size for postmenopausal patients. Of the 4,077 patients, 815 (20%) met criteria for the highest risk groups, and 10-year cumulative incidences were 35% for premenopausal and 34% for postmenopausal women. Conclusion: LRFs are a significant problem after mastectomy alone even for some patients with node-negative breast cancer, as well as after mastectomy and adjuvant treatment for some subgroups of patients with node-positive disease. In addition to number of positive lymph nodes, predictors of LRF include tumor-related factors, such as vascular invasion, higher grade, and larger size.

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