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Local breast cancer recurrence risk decreases as event-free years increase
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The 5-year risk for local recurrence as a first event after breast cancer treatment was less than 3% for most breast cancer subtypes, according to data presented during the plenary session of the Society for Surgical Oncology’s Annual Cancer Symposium.
The overall risk further dropped to less than 1% for most subtypes after 3 event-free years, results showed.
Women regularly receive a physical examination and mammography for 5 years after treatment for breast cancer to monitor local and regional recurrences, according to study background.
Research has suggested that the chances of recurrence may decrease after an event-free interval, to the point where follow-up may no longer be useful.
Martine Moossdorff, MD, a surgeon at Maastricht University Medical Center in the Netherlands, and colleagues sought to determine the risk for local recurrence as a first event within 5 years of breast cancer diagnosis, conditional to being event free for 1, 2, 3 and 4 years.
Researchers used the National Cancer Registry to evaluate data from 51,239 breast cancers diagnosed between 2005 and 2008, of which 67.2% (n = 34,453) had 5-year follow-up data.
Overall, 2.5% of patients (n = 874) had a local recurrence as their first event within 5 years. The risk for local recurrence steadily dropped after each event-free year before the end of regular follow-up (1 year, 2%; 2 years, 1.4%; 3 years, 0.9%; 4 years, 0.4%).
Women with triple-negative breast cancer (n = 3,619) had the highest risk for local recurrence (5.6%), whereas women with ER-positive, PR-positive, HER-2–negative breast cancer (1.9%) had the lowest risk.
Among subtypes with a high baseline risk — such as triple-negative or ER-negative breast cancers — the recurrence risk remained highest in the first 3 years. A strong decrease occurred in the next 2 years, to the point where it approximated the risk of the other subtypes.
The risk for local recurrence after 3 event-free years was less than 1% in all subtypes except triple-negative breast cancer (1.2%).
“The improvement in prognosis is reassuring to patients during follow-up,” Moossdorff and colleagues wrote. “It also suggests that follow-up beyond 3 years may be of limited value because of the low yield, both for individual follow-up and clinical studies using local recurrence as the primary outcome.” – by Cameron Kelsall
Reference:
Van Nijnatten T, et al. Abstract 4. Presented at: Society for Surgical Oncology Annual Cancer Symposium; March 2-5, 2016; Boston.
Disclosure: HemOnc Today could not confirm the researchers’ relevant financial disclosures at the time of reporting.