A risk score based on histopathological features predicts higher risk of distant recurrence in premenopausal patients with lymph node-negative endocrine-responsive breast cancer

Breast. 2012 Oct;21(5):621-8. doi: 10.1016/j.breast.2012.06.003. Epub 2012 Jun 29.

Abstract

Purpose: To develop a Risk Score (RS) to predict distant recurrence among premenopausal women with node-negative endocrine-responsive early breast cancer.

Methods: The Cox model was used to develop the RS using clinical and histopathological features from 378 women participating in the IBCSG Trial VIII who received endocrine therapy alone or following chemotherapy. The performance of the resulting model was validated on a cohort of 1005 patients from a single institution who received endocrine therapy alone.

Results: In a multivariable analysis, the risk of distant recurrence was associated with tumor size, ER, Ki-67 and peritumoral vascular invasion. In the validation cohort, patients with high RS were at greater risk of distant recurrence compared to patients with low RS (HR, 17.41; 95% CI, 5.72-52.95).

Conclusion: In premenopausal women with node-negative endocrine-responsive early breast cancer, the RS identifies patients at higher risk of distant recurrence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Antineoplastic Agents, Hormonal / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Chemotherapy, Adjuvant
  • Cyclophosphamide / therapeutic use
  • Decision Support Techniques
  • Female
  • Fluorouracil / therapeutic use
  • Goserelin / administration & dosage
  • Humans
  • Ki-67 Antigen / metabolism
  • Methotrexate / therapeutic use
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Neoplasm Metastasis*
  • Nomograms
  • Premenopause
  • Randomized Controlled Trials as Topic
  • Receptors, Estrogen / metabolism
  • Risk Assessment
  • Survival Analysis
  • Tamoxifen / administration & dosage
  • Treatment Outcome
  • Tumor Burden

Substances

  • Antineoplastic Agents, Hormonal
  • Ki-67 Antigen
  • Receptors, Estrogen
  • Tamoxifen
  • Goserelin
  • Cyclophosphamide
  • Fluorouracil
  • Methotrexate

Supplementary concepts

  • CMF regimen