Predicting the Risk of Breast Cancer Recurrence

"What are the chances of it coming back?" is one of the most common questions posed by women who survive breast cancer, and a difficult one to answer considering the limited studies that have evaluated that risk or the characteristics associated with recurrence of the disease. However, a new study may provide the information oncologists need to help not only answer this difficult question but make more informed decisions regarding the patients' treatment. "Now we can tell some women within a certain percentage their future risk of recurrence and clinicians may be able to make more informed decisions regarding prescription of extended...therapy," said lead researcher Abenaa Brewster M.D., assistant professor at the University of Texas M. D. Anderson Cancer Center in Houston.

For the study, published in the Journal of the National Cancer Institute, Dr. Brewster and colleagues tracked 2,838 U.S. women who had been diagnosed with Stage I through III breast cancers and had been treated between 1985 and 2001 at the cancer center. The women had remained cancer-free for five years after treatment with adjuvant systemic therapy (AST), such as chemotherapy and or hormone therapy. The study did not include women who had received some of the more recent treatments, such as Herceptin or aromatase inhibitors.

After an average follow-up period of 28 months, 216 of the women had a recurrence of the disease. For those treated for stage I breast cancer—a small tumor which had not spread—there was a 7 percent recurrence of breast cancer after five years; stage II—a larger tumor that may have spread to the lymph nodes—had an 11 percent rate of recurrence, and stage III—larger tumor which may have spread to additional lymph nodes or grown into the chest wall or skin of the breast—experienced a 13 percent recurrence. Also, women who had estrogen receptor positive tumors had a greater late recurrence rate, compared to women whose tumors were not this type. "I actually think that patients think that the risk is a lot higher than it is. So I hope that this paper somewhat reassures them that their risk of recurrence after they are five-year survivors is probably not as high as they think it is," Dr. Brewster told Reuters Health.

With an estimated 465,000 deaths each year, breast cancer is the top cause of cancer death among women worldwide, according to the American Cancer Society.