ER Positive BC

123JustMe

Annual Hazard Rates of Recurrence for Breast Cancer During 24 Years of Follow-Up

Journal of Clinical Oncology

1 Expert Comment

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TAKE-HOME MESSAGE

• In this pooled analysis of International Breast Cancer Study Group clinical trials I to V, annualized hazard rates were estimated using data from 4105 patients. The highest annualized hazard rate of recurrence was in the first 5 years (10.4%), but was lower in ER-negative than ER-positive disease (9.9% vs 11.5%; P = .01). After the first 5 years, the annualized hazard of recurrence was consistently higher for ER-positive than ER-negative patients.
• The authors conclude that ER-positive breast cancer patients have a significant risk of recurrence in extended follow-up.

Loral

Lucky us...NOT!

123JustMe

ER positive BC patients need greater surveillance. Please read the expert comments

leggo

I can certainly throw my agreement behind that one. Triple positive, cancer free for almost 11 years, then boom! By the sixth year I really, really thought either they made a mistake or I actually beat it. Joke was on me! The more triple positive women I get to know, the more accurate that report seems. Just one more depressing fact about that positive status.

JohnSmith

In regards to the study, here's the "Expert Comment" written by: Lee Schwartzberg MD (Clinical Professor of Medicine, University of Tennessee College of Medicine & Medical Director, The West Clinic)

"We used to consider the 5-year mark of relapse-free survival the hallmark of successful anticancer treatment. If it didn't come back by then, the patient was in the clear, right? Unfortunately, the 5-year time point is not a particularly good one for breast cancer, and this is especially true when we consider the various subtypes of breast cancer. ER+ breast cancer has a long natural history, with over half of the recurrence events occurring after 5 years. There are little data on very long follow-up of patients with breast cancer in a clinical trial setting, where data are likely to be most accurate. The investigators from the IBCSG present 24-year follow-up in this report, and, while there are no surprises, it is interesting to observe that, after the early phase, survival curves cross for ER- and ER+ breast cancer, with the ER+ patients actually at greater risk (although low) from years 10 to 25. It may be time to rethink surveillance based on subtype. Patients with triple-negative cancers could be seen much more frequently in the first 2 to 3 years, perhaps every 2 to 3 months, and then follow-up discontinued at 5 years due to low base rate. On the other hand, patients with ER+ tumors appear to require tumor surveillance for at least 10 years once or twice a year, and perhaps even longer."

Meow13

We have to wait 25 years, and still maybe not in the clear. Better find a cure.

Lily55

I wonder why?

JohnSmith

Lily. Numerous reasons. This thread (which you probably read), here, from last week discusses ER+ dormancy.

How about this example of a ER+ recurrence (mets) 4 decades after initial diagnosis?
Read this case report: An 81-year-old patient with distant metastasis of ILC occurring 41 years after mastectomy.
- Diagnosed with ILC in 1971 at age 41, had a Mastectomy
- Recurrence in 1975 at age 45, had a Oophorectomy
- Remained disease free until 2012 when they discovered ILC mets.

Mind boggling! It's one of the reasons why I research nearly everyday.

farmerlucy

Oh Good God! 41 years. The only solution is to live each day to its fullest. Hugs all around.