The risk of late relapse among certain groups of patients with breast cancer are revealed in a paper published online in Nature this week. This modelling study could improve the identification of high-risk patients and lead to new treatments for these groups.
The risk of cancer recurrence in patients with breast cancer varies greatly depending on the biology of the tumour. Better understanding of these risks could refine long-term treatments and improve outcomes for patients.
Christina Curtis and colleagues have modelled the different risks of breast cancer relapse and mortality over time in 3,240 patients in the UK and Canada who were diagnosed between 1977 and 2005. The model accounts for different disease states (for example, how far the recurrent tumour is located from the original tumour), time since surgery, and other factors that are known to influence mortality, such as age and tumour size. The authors identified four subtypes with late-recurring tumours. These included 26 per cent of oestrogen receptor positive (ER+) and human epidermal growth factor receptor 2-negative (HER2-) tumours, which had a 42-55 per cent risk of recurrence up to 20 years after diagnosis.
These findings could provide important information to refine relapse risk estimates and improve follow-up and stratification of patients with breast cancer. However, further research will be required to investigate whether better-targeted treatments can change the outcome of different breast cancer subtypes.