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).
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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.
Reference: Faneyte I, Peterse J, van Tinteren H, et al. Predicting early failure after adjuvant chemotherapy in high-risk breast cancer patients with extensive lymph node involvement. Clinical Cancer Research. 2004;10, 4457-4463
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