Certain
Features Predict for Recurrence and Death in Early Breast
Cancer
According to a recent article published in Clinical Cancer
Research, certain characteristics of cancer predict for a
recurrence within 2 years of treatment in women diagnosed
with early breast cancer, which can lead to an early death.
Breast cancer claims the lives of nearly 40,000 women annually
in the United States. Patients diagnosed with early breast
cancer, or breast cancer that has not spread far from its
site of origin, often have high cure rates following standard
treatment. However, a large fraction of women with early breast
cancer still experience a cancer recurrence and death from
their disease. Researchers continue to evaluate specific "markers"
or characteristics of the cancer and/or the patient to determine
which women are at a higher risk of developing a recurrence,
particularly an early recurrence, which is associated with
an increased risk of death from breast cancer. These patients
may wish to opt for more aggressive treatment options in an
attempt to improve their long-term outcomes.
Researchers from the Netherlands recently conducted a clinical
trial to evaluate clinical features of breast cancers and
patients that have been diagnosed with early breast cancer
and possible associations between these variables and outcomes.
This trial included nearly 740 women who were 56 years of
age or younger and had been diagnosed with breast cancer that
had spread to 4 or more axillary (under the arm) lymph nodes,
but could not be detected elsewhere in the body. All patients
underwent surgery and anthracycline-based chemotherapy (either
conventional or higher-dose chemotherapy). Early recurrences
(within 2 years of treatment) occurred in 19% of patients.
The average duration of survival for these patients after
recurrence was less than one year.
Patients with the following characteristics were strongly
associated with having an early recurrence: estrogen and/or
progesterone receptor-negative cancers, the genetic variations
referred to as p27 negativity or p53 positivity, HER2 overexpression,
young age, large cancer, invasion of blood vessels, 10 or
more involved lymph nodes, aggressive cancers, or cancer spread
to the highest (apical) axillary lymph node. All of these
characteristics, except for the size of the cancer, also predicted
for an early death from breast cancer in this group of patients.
Patients were at 3 times the risk of an early recurrence and
5 times the risk of an early death from breast cancer if they
possessed these 3 features: estrogen-receptor negative cancer,
cancer spread to 10 or more lymph nodes, and an aggressive
cancer (grade 3).
The researchers concluded that specific characteristics,
particularly a combination of estrogen receptor-negative cancers,
an aggressive cancer, and cancer spread to 10 or more axillary
lymph nodes, puts patients diagnosed with early breast cancer
at risk for a cancer recurrence within 2 years of treatment
and also puts them at risk for an early death. Patients with
these features may benefit from more aggressive treatment
than their counterparts. Patients with any of these features
may wish to speak with their physician about their individual
risks and benefits of more aggressive therapy and/or the participation
in a clinical trial evaluating novel therapeutic approaches.
Two sources of information regarding ongoing clinical trials
include the National Cancer Institute (cancer.gov) and www.cancerconsultants.com.
Personalized clinical trial searches are also performed at
www.cancerconsultants.com.
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