Dutch Study Indicates Low Locoregional Recurrence in Young Women With Early-Stage Breast Cancer
Aalders et al found relatively low rates of locoregional recurrence among young (< 35 years) Dutch women undergoing surgery for unilateral invasive breast cancer between 2003 and 2008. Recurrence rates varied somewhat by biologic subtype, according to these findings reported in the Journal of Clinical Oncology.
Recurrence Rates
The study involved data from 1,000 patients in the Netherlands Cancer Registry. Of them, 59% had a known biologic subtype: 39% had hormone receptor–positive/HER2-negative disease; 17% had hormone receptor–positive/HER2-positive disease; 10% had hormone receptor–negative/HER2-positive disease; and 34% had triple-negative disease.
Overall, 5-year rates were 3.5% for local recurrence and 3.7% for regional recurrence, with a nonsignificant decrease observed between 2003 (4.2% and 6.1%) and 2008 (3.2% and 4.4%). The rate of distant metastasis significantly decreased over time (from 18% to 10%, P = .04).
By Subtype
Rates of local recurrence (P = .056) and regional recurrence (P = .014) differed by subtype over the total study duration, but not after the introduction of trastuzumab (Herceptin) in 2005 (P = .24, P = .42). Overall, patients with hormone receptor–negative/HER2-positive disease had the highest rate of local recurrence (5.6%), and patients with triple-negative disease had the highest rate of regional recurrence (3.4%). Patients with hormone receptor–positive disease had a 1% risk of local recurrence irrespective of HER2 status.
Risk for recurrence was not affected by the type of surgery; local recurrence rates were 3.2% after breast-conserving surgery and 3.8% after mastectomy (P = .617). Lymph node involvement at the time of surgery was associated with an increased risk of regional recurrence (P = .035); risk was increased in each biomarker subtype, but significantly only in the triple-negative group (P = .04).
The investigators concluded: “Overall, the rates of [local recurrence] and [regional recurrence] in young patients with early-stage breast cancer were relatively low and varied by biomarker subtype.”
Kim C. Aalders, MD, of Diakonessenhuis, Utrecht, the Netherlands, is the corresponding author of the Journal of Clinical Oncology article.
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