‘Real Life' Study Clarifies Risk Of Recurrence For High-Risk Breast Cancer Patients

High-risk breast cancer patients do not appear to have a higher risk of relapse than the general breast cancer population
during the first two years after diagnosis, unless their cancer has spread to more than 10 axillary lymph nodes, Italian
researchers reported today at the 2nd ESMO Scientific & Educational Conference (ESEC) in Budapest, Hungary.


Dr. Marina Cazzaniga from Treviglio Hospital, Italy, and colleagues in the NORA study, have been studying 3,500 patients
being treated for breast cancer. They identified five groups of patients considered at high risk and analyzed their rate of
relapse.


The five groups were:

* patients whose tumors were estrogen receptor positive/progesterone receptor negative (ER+/PgR-)

*those who had tumors with a 3+ score for HER2 protein overexpression

* those with 1 to 3 positive axillary nodes

* those with 4 to 10 positive nodes

* patients with more than 10 positive nodes


"We found that patients with ER+/PgR- status, or high expression of HER2 or fewer than 10 positive axillary nodes do not seem
to have an increased risk of relapse in comparison to the whole population," Dr. Cazzaniga said. "Massive involvement of
axillary nodes seems to be the only factor associated with a higher risk of developing distant or local relapse."


"Our results reflect what happens in an unselected population of breast cancer patients, so they are very close to the
clinical reality," Dr. Cazzaniga added. "In clinical practice, benefits do not derive only from one study, but from an
accurate use of different strategies resulting from different trials and tailored to individual patients. Our study probably
reflects the magnitude of benefits of the application of various studies on the whole population."


The finding could be very important for patients, she said. "The identification of peculiar characteristics allows clinicians
to design specific therapies for specific patients. That's why results must fit clinical practice."


Median follow-up in the study so far is 21.7 months. The risk of recurrence in breast cancer patients presents 2 peaks: the
first approximately within 2 years, the second 5 years after surgery.


"We believe our results well describe the natural history of breast cancer in the first 2 years. Longer follow-up will
demonstrate if also the second peak changes or not," Dr. Cazzaniga said.


Commenting on the report, Dr. Ahmad Awada from Jules Bordet Institute, Brussels, Belgium, said, "At this time we do not know
which patients would benefit most from upfront therapy with aromatase inhibitors compared to the sequential approach of
Tamoxifen followed by aromatase inhibitors. This paper showed that patients with N+>10 had an increased risk of relapse
during the first 2 years. Consequently, these data called for an upfront use of adjuvant AI in this group of patients at high
risk of relapse in the first 2 years."


About the European Society for Medical Oncology (ESMO)


ESMO is Europe's leading professional society providing education and clinical guidelines for medical oncologists and other
healthcare professionals, working to ensure optimal care for cancer patients. Currently, with 4,500 members, ESMO is
represented in every European country and the six major geographical areas of the world. Since its inception in 1975, ESMO
has consistently promoted its belief that every cancer patient is entitled to the best possible treatment available. The use
of medicine is now a fundamental aspect of cancer therapy and, consequently, cancer patients need to be treated by qualified
medical oncologists. Through its flagship scientific journal, Annals of Oncology, ESMO publishes research results on all
aspects of clinical oncology. Donations to the ESMO Foundation support ESMO activities as well as cancer research. More
information about the Society is available at esmo


About the 2nd ESEC Conference


This unique educational conference is designed to offer updates on state-of-the-art oncology for the major tumor types as
well as special interactive sessions for young medical oncologists.
Highlighting the conference are new developments in treatment, advances in basic science and health services, as well as
methods of providing supportive care to cancer patients. Special sessions focus on new ESMO Minimum Clinical Recommendations,
how to handle medical oncology emergencies, and cancer in Central and Eastern Europe.



Reference URL

esmo/PressRoom


SOURCE: alphagalileo