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Comparison of breast cancer recurrence and outcome patterns between patients treated in 1986-1992 and 2004-2008.

Abstract No:
521
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2014 ASCO Annual Meeting!

Session: Breast Cancer - HER2/ER
Type: Poster Highlights Session
Time 1: Sunday June 1, 8:00 AM to 11:00 AM
Location 1: E354b

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Time 2: Sunday June 1, 11:30 AM to 12:45 PM
Location 2: E Arie Crown Theater

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Author(s): Rachel Jorge Dino Cossetti, Scott Tyldesley, Caroline Speers, Karen A. Gelmon; BC Cancer Agency, Vancouver, BC, Canada; British Columbia Cancer Agency, Vancouver, BC, Canada
Abstract Disclosures

Abstract:

Background: Different patterns of breast cancer (BC) recurrence overtime have been reported according to estrogen receptor (ER) status. We report a change in BC recurrence patterns. Methods: Females with biopsy proven BC, stages I-III, treated at the BCCA 1986-1992 (cohort 1 – C1) and mid 2004-2008 (cohort 2 – C2), with known ER and HER2 status were eligible. Data was prospectively collected. C2 cases were matched to C1 by random case selection for grade and stage to adjust for imbalances. Endpoints were annual hazard rates of recurrence (HRR) and annual hazard rates of death (HRD). Results: After random sampling, 10,283 pts were included: 3672 in C1 and 6611 in C2. BC subtypes in C1 and C2 were, respectively, ER+/HER2-: 71.2 vs 64.8%; ER+/HER2+: 6.7 vs 11.7%; ER-/HER2+: 6.5 vs 8.2%; ER-/HER2-: 15.5 vs 15.3%. The HRR per yearly interval (up to year 9) for all subtypes have halved in C2. For ER+/HER2- BC, HRR in C2 was half of the HRR in C1. Differences in HRR between C1 and 2 were greater in the initial 5 intervals for HER2+ and triple-negative (TN) BC. The HRD have also decreased, but to a lesser extent. Conclusions: Outcomes have improved for all BC subtypes, but particularly for HER2+ and TN BC. The early spike in disease recurrence has markedly decreased. These contemporary hazard rates are important for treatment decisions and patient discussions, but also for planning of early BC trials.

HRR (%)
Yearly interval		0-1	1-2	2-3	3-4	4-5	5-6	6-7	7-8	8-9
Cohort 1		4.7±0.4	8.8±0.5	6.8±0.5	5.0±0.4	4.2±0.4	3.7±0.4	3.0±0.4	3.1±0.4	1.8±0.3
Cohort 2		2.7±0.2	4.0±0.3	3.6±0.2	2.6±0.2	2.0±0.2	1.3±0.2	1.2±0.2	1.2±0.3	0.3±0.3
ER+/HER2-	C1 C2	2.7±0.3	6.2±0.5	5.0±0.5	4.3±0.5	4.1±0.5	4.1±0.5	3.3±0.4	3.4±0.5	1.9±0.4
		1.5±0.2	2.5±0.2	3.0±0.3	2.2±0.2	1.9±0.2	1.4±0.2	1.7±0.3	1.3±0.4	0.4±0.4
ER+/HER2+	C1 C2	6.7±1.7	13.7±2.5	12.1±2.6	21.6±2.6	6.9±2.2	3.7±1.7	3.2±1.6	4.3±1.9	2.8±1.6
		2.5±0.6	3.1±0.7	3.9±0.7	3.0±0.7	2.7±0.7	1.8±0.6	0.3±0.3	0.7±0.7	0
ER-/HER2+	C1 C2	13.9±2.5	23.6±3.6	17.0±3.4	7.8±2.5	6.8±2.4	2.7±1.6	1.8±1.3	1.9±1.3	2.0±1.4
		4.0±0.9	8.3±1.3	5.5±1.1	3.0±0.8	1.3±0.6	0.3±0.3	0	1.7±1.2	0
TNBC	C1 C2	9.4±1.3	14.6±1.7	11.0±1.6	5.3±1.2	2.5±0.8	1.5±0.7	1.8±0.7	1.6±0.7	1.3±0.6
		7.3±0.9	9.1±1.0	5.5±0.8	3.8±0.7	2.0±0.5	0.7±0.4	0.5±0.3	0.9±0.6	0