Development of a Prognostic Tool to Guide the Decision to Extend Adjuvant Aromatase Inhibitors for up to Ten Years in Postmenopausal Early Breast Cancer Patients
<i>Background:</i> The selection of women with hormone receptor-positive (HR+) early breast cancer (EBC) at high risk of relapse after five years (yrs.) of adjuvant aromatase inhibitors (AIs) is crucial, as the benefit of extending AIs is counterbalanced by toxicity. We developed a clini...
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doaj-0c339e5fcf6945709391d806352b71b32020-12-12T00:03:52ZengMDPI AGCancers2072-66942020-12-01123725372510.3390/cancers12123725Development of a Prognostic Tool to Guide the Decision to Extend Adjuvant Aromatase Inhibitors for up to Ten Years in Postmenopausal Early Breast Cancer PatientsCamille Moreau-Bachelard0Loïc Campion1Marie Robert2Olivier Kerdraon3Céline Renaudeau4Maud Aumont5Jean-Marc Classe6Mario Campone7Jean-Sébastien Frénel8Department of Medical Oncology, Institut de Cancérologie de l’Ouest, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, FranceDepartment of Biometrics, Institut de Cancérologie de l’Ouest, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, FranceDepartment of Medical Oncology, Institut de Cancérologie de l’Ouest, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, FranceDepartment of Pathology, Institut de Cancérologie de l’Ouest, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, FranceDepartment of Surgery, Institut de Cancérologie de l’Ouest, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, FranceDepartment of Radiation Oncology, Institut de Cancérologie de l’Ouest, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, FranceDepartment of Surgery, Institut de Cancérologie de l’Ouest, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, FranceDepartment of Medical Oncology, Institut de Cancérologie de l’Ouest, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, FranceDepartment of Medical Oncology, Institut de Cancérologie de l’Ouest, Boulevard Professeur Jacques Monod, 44800 Saint-Herblain, France<i>Background:</i> The selection of women with hormone receptor-positive (HR+) early breast cancer (EBC) at high risk of relapse after five years (yrs.) of adjuvant aromatase inhibitors (AIs) is crucial, as the benefit of extending AIs is counterbalanced by toxicity. We developed a clinicopathological tool to estimate the residual risk of relapse after five years of adjuvant AIs. <i>Methods:</i> The Institut de Cancérologie de l’Ouest (ICO) database was used to determine a prognostic score of post-five-year AI relapse. Cox regression models estimated our score’s prognostic performance. <i>Results:</i> In total, 1105 women were included. Median follow-up was 44 months (IQR = 21–70) post-AI treatment. From the Cox models, we designed a dichotomous prognostic score including the number of macrometastases, age (>70 yrs. vs. ≤70 yrs.), tumor size (≥T2 vs. not), and mitotic activity (≥2 vs. not). Overall, 77.5% of patients were classified as being at low risk and 22.5% at high risk of late recurrence. Low-risk patients had a five- to ten-year local or distant recurrence risk of 7.6% (95% CI, 5.4% to 10.6%) as compared with 26.9% (95% CI, 19.9% to 35.7%) for the high-risk roup. <i>Conclusion:</i> In this study, we developed a simple tool to identify women at high risk of relapse despite completing five years of AIs.https://www.mdpi.com/2072-6694/12/12/3725early breast cancerhormone receptorpositivelate recurrence |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Camille Moreau-Bachelard Loïc Campion Marie Robert Olivier Kerdraon Céline Renaudeau Maud Aumont Jean-Marc Classe Mario Campone Jean-Sébastien Frénel |
spellingShingle |
Camille Moreau-Bachelard Loïc Campion Marie Robert Olivier Kerdraon Céline Renaudeau Maud Aumont Jean-Marc Classe Mario Campone Jean-Sébastien Frénel Development of a Prognostic Tool to Guide the Decision to Extend Adjuvant Aromatase Inhibitors for up to Ten Years in Postmenopausal Early Breast Cancer Patients Cancers early breast cancer hormone receptor positive late recurrence |
author_facet |
Camille Moreau-Bachelard Loïc Campion Marie Robert Olivier Kerdraon Céline Renaudeau Maud Aumont Jean-Marc Classe Mario Campone Jean-Sébastien Frénel |
author_sort |
Camille Moreau-Bachelard |
title |
Development of a Prognostic Tool to Guide the Decision to Extend Adjuvant Aromatase Inhibitors for up to Ten Years in Postmenopausal Early Breast Cancer Patients |
title_short |
Development of a Prognostic Tool to Guide the Decision to Extend Adjuvant Aromatase Inhibitors for up to Ten Years in Postmenopausal Early Breast Cancer Patients |
title_full |
Development of a Prognostic Tool to Guide the Decision to Extend Adjuvant Aromatase Inhibitors for up to Ten Years in Postmenopausal Early Breast Cancer Patients |
title_fullStr |
Development of a Prognostic Tool to Guide the Decision to Extend Adjuvant Aromatase Inhibitors for up to Ten Years in Postmenopausal Early Breast Cancer Patients |
title_full_unstemmed |
Development of a Prognostic Tool to Guide the Decision to Extend Adjuvant Aromatase Inhibitors for up to Ten Years in Postmenopausal Early Breast Cancer Patients |
title_sort |
development of a prognostic tool to guide the decision to extend adjuvant aromatase inhibitors for up to ten years in postmenopausal early breast cancer patients |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2020-12-01 |
description |
<i>Background:</i> The selection of women with hormone receptor-positive (HR+) early breast cancer (EBC) at high risk of relapse after five years (yrs.) of adjuvant aromatase inhibitors (AIs) is crucial, as the benefit of extending AIs is counterbalanced by toxicity. We developed a clinicopathological tool to estimate the residual risk of relapse after five years of adjuvant AIs. <i>Methods:</i> The Institut de Cancérologie de l’Ouest (ICO) database was used to determine a prognostic score of post-five-year AI relapse. Cox regression models estimated our score’s prognostic performance. <i>Results:</i> In total, 1105 women were included. Median follow-up was 44 months (IQR = 21–70) post-AI treatment. From the Cox models, we designed a dichotomous prognostic score including the number of macrometastases, age (>70 yrs. vs. ≤70 yrs.), tumor size (≥T2 vs. not), and mitotic activity (≥2 vs. not). Overall, 77.5% of patients were classified as being at low risk and 22.5% at high risk of late recurrence. Low-risk patients had a five- to ten-year local or distant recurrence risk of 7.6% (95% CI, 5.4% to 10.6%) as compared with 26.9% (95% CI, 19.9% to 35.7%) for the high-risk roup. <i>Conclusion:</i> In this study, we developed a simple tool to identify women at high risk of relapse despite completing five years of AIs. |
topic |
early breast cancer hormone receptor positive late recurrence |
url |
https://www.mdpi.com/2072-6694/12/12/3725 |
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