Later recurrence of breast cancer is associated with more favourable clinical outcomes

March 2022 Science Nalinee Pathak

A recent study from the Danish Breast Cancer Group (DBCG) reported that the late recurrence of breast cancer is associated with a better prognosis. The findings of this study were published in the Journal of Clinical Oncology.

The DBCG investigated the risk of breast cancer on patient mortality, evaluated the prognostic factors, and compared survival after later recurrence with survival after early recurrence.

Study design

Using the DBCG and other national databases, the researchers identified women with breast cancer who were alive six months after recurrence. The mortality rates (MRs) were calculated per 1000 person-years. Additionally, they estimated cumulative breast cancer mortality for early versus late recurrence by primary tumours and late recurrence characteristics. The researchers used Cox regression and calculated adjusted hazard ratios (HRs) for breast cancer death, accounting for death from other causes as competing risks.

Major findings

In the study, there were 2,004 breast cancer patients with late recurrence, out of which 721 had died of breast cancer (median survival=10 years, mortality rate=84.8/1000 person-years, 10-year cumulative mortality=50%). Likewise, the study included 1,526 patients with early recurrence, of which 1,092 died due to breast cancer (median survival= four years, mortality rate=173.9/1000 person-years, 10-year cumulative mortality=72%).

Notably, the research team observed a lower risk of breast cancer-specific death in patients with late recurrence than patients with early recurrence of breast cancer (HR 0.72; 95% CI 0.62 to 0.85). Further, the increased mortality after late recurrence was associated with advanced stage at primary diagnosis, distant metastases, adjuvant treatment for locoregional recurrence, and systemic treatment for distant recurrence.

Conclusion

Breast cancer patients with late recurrence are associated with less aggressive disease and a favourable clinical prognosis. Localisation of recurrent breast cancer was the main prognostic factor for breast cancer-associated mortality.

Reference

Pedersen RN, Mellemkjær L, Ejlertsen B, et al. Mortality After Late Breast Cancer Recurrence in Denmark. Journal of Clinical Oncology; Published online 16 February 2022. DOI: 10.1200/JCO.21.02062

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