Understanding Risk of Recurrence
in Breast Cancer

Estrogen receptor positive (ER+) and Node-negative (LN-) status at time of initial diagnosis for breast cancer has long been associated with a favorable patient outcome. However, long-term risks of recurrence and death from breast cancer in these patients are not well understood.  Modern genomic testing is beginning to shed more light on the risks faced by patients even 10 years after their initial diagnosis and treatment. 

Many people have the misconception that after successful initial treatment, patients with early breast cancer who remain disease free for five years or more (according to existing tests) are unlikely to experience a recurrence of their cancer. However, recurrences can and do occur after five years, although the risk does drop appreciably.

In a recent meta-analysis of seven different studies including more than 3,500 patients who had received some type of post-surgical adjuvant therapy for breast cancer, risk of cancer recurrence was greatest during the first two years following surgery. After this period, the research showed a steady decrease in the risk of recurrence until year five, when the risk of recurrence declined slowly and remained at an average of 4.3% per year.

Interestingly, a substantial proportion of breast cancer recurrences seen in this study occurred more than five years after surgery, between years six and 12.  These recurrences happened even in patients who were considered at low risk for recurrence due to the presence of ER+, LN- disease. This research indicates that through at least 12 years of follow-up, the risk of breast cancer recurrence remains appreciable, and even some patients considered low risk have some risk of the cancer coming back.*

New gene-based signatures, including Aviara H/I^SM and Aviara MGI^SM (Molecular Grade Index), can further stratify patients into low, intermediate and high risk of recurrence groups based on the molecular characteristics of the tumor.  This provides the oncologist and the breast cancer patient more information that may assist in making more appropriate front-line treatment decisions.

*Go to www.lifeabc.org for more information.

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