Annual Hazard Rates of Recurrence for Breast Cancer During 24 Years of Follow-Up: Results From the International Breast Cancer Study Group Trials I to V.
- Colleoni M Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland. marco.colleoni@ieo.it.
- Sun Z Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- Price KN Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- Karlsson P Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- Forbes JF Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- Thürlimann B Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- Gianni L Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- Castiglione M Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- Gelber RD Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- Coates AS Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- Goldhirsch A Marco Colleoni and Aron Goldhirsch, European Institute of Oncology and International Breast Cancer Study Group, Milan; Lorenzo Gianni, Ospedale degli Infermi and Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Rimini, Italy; Zhuoxin Sun, Karen N. Price, and Richard D. Gelber, International Breast Cancer Study Group Statistical Center and Frontier Science and Technology Research Foundation; Zhuoxin Sun and Richard D. Gelber, Harvard T.F. Chan School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA; Per Karlsson, Institute of Selected Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden; John F. Forbes, Australia and New Zealand Breast Cancer Trials Group, University of Newcastle, Newcastle Mater Hospital, Newcastle; Alan S. Coates, International Breast Cancer Study Group and University of Sydney, Sydney, New South Wales, Australia; Beat Thürlimann, Breast Center Kantonsspital, St Gallen, and Swiss Group for Clinical Cancer Research; and Monica Castiglione, International Breast Cancer Study Group, Bern, Switzerland.
- 2016-01-21
Published in:
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology. - 2016
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
Breast Neoplasms
Disease-Free Survival
Female
Follow-Up Studies
Humans
Middle Aged
Neoplasm Recurrence, Local
Proportional Hazards Models
Randomized Controlled Trials as Topic
Survival Rate
Young Adult
English
PURPOSE
Predicting the pattern of recurrence can aid in the development of targeted surveillance and treatment strategies. We identified patient populations that remain at risk for an event at a median follow-up of 24 years from the diagnosis of operable breast cancer.
PATIENTS AND METHODS
International Breast Cancer Study Group clinical trials I to V randomly assigned 4,105 patients between 1978 and 1985. Annualized hazards were estimated for breast cancer-free interval (primary end point), disease-free survival, and overall survival.
RESULTS
For the entire group, the annualized hazard of recurrence was highest during the first 5 years (10.4%), with a peak between years 1 and 2 (15.2%). During the first 5 years, patients with estrogen receptor (ER)--positive disease had a lower annualized hazard compared with those with ER-negative disease (9.9% v 11.5%; P = .01). However, beyond 5 years, patients with ER-positive disease had higher hazards (5 to 10 years: 5.4% v 3.3%; 10 to 15 years: 2.9% v 1.3%; 15 to 20 years: 2.8% v 1.2%; and 20 to 25 years: 1.3% v 1.4%; P < .001). Among patients with ER-positive disease, annualized hazards of recurrence remained elevated and fairly stable beyond 10 years, even for those with no axillary involvement (2.0%, 2.1%, and 1.1% for years 10 to 15, 15 to 20, and 20 to 25, respectively) and for those with one to three positive nodes (3.0%, 3.5%, and 1.5%, respectively).
CONCLUSION
Patients with ER-positive breast cancer maintain a significant recurrence rate during extended follow up. Strategies for follow up and treatments to prevent recurrences may be most efficiently applied and studied in patients with ER-positive disease followed for a long period of time.
Predicting the pattern of recurrence can aid in the development of targeted surveillance and treatment strategies. We identified patient populations that remain at risk for an event at a median follow-up of 24 years from the diagnosis of operable breast cancer.
PATIENTS AND METHODS
International Breast Cancer Study Group clinical trials I to V randomly assigned 4,105 patients between 1978 and 1985. Annualized hazards were estimated for breast cancer-free interval (primary end point), disease-free survival, and overall survival.
RESULTS
For the entire group, the annualized hazard of recurrence was highest during the first 5 years (10.4%), with a peak between years 1 and 2 (15.2%). During the first 5 years, patients with estrogen receptor (ER)--positive disease had a lower annualized hazard compared with those with ER-negative disease (9.9% v 11.5%; P = .01). However, beyond 5 years, patients with ER-positive disease had higher hazards (5 to 10 years: 5.4% v 3.3%; 10 to 15 years: 2.9% v 1.3%; 15 to 20 years: 2.8% v 1.2%; and 20 to 25 years: 1.3% v 1.4%; P < .001). Among patients with ER-positive disease, annualized hazards of recurrence remained elevated and fairly stable beyond 10 years, even for those with no axillary involvement (2.0%, 2.1%, and 1.1% for years 10 to 15, 15 to 20, and 20 to 25, respectively) and for those with one to three positive nodes (3.0%, 3.5%, and 1.5%, respectively).
CONCLUSION
Patients with ER-positive breast cancer maintain a significant recurrence rate during extended follow up. Strategies for follow up and treatments to prevent recurrences may be most efficiently applied and studied in patients with ER-positive disease followed for a long period of time.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1200/JCO.2015.62.3504
- PMID 26786933
- Persistent URL
- https://sonar.ch/global/documents/13281
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