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Old 05-20-2014, 11:18 AM   #1
'lizbeth
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Post We've come a long way, Baby!

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

Abstract No:
521
Attend this session at the
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

Time 2: Sunday June 1, 11:30 AM to 12:45 PM
Location 2: E Arie Crown Theater
Personalize your Meeting experience with a suggested or customized itinerary!

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
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Old 05-20-2014, 11:38 AM   #2
'lizbeth
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Re: We've come a long way, Baby!

What a difference a decade and a half makes in breast cancer treatment advances:

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
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

Please note this is a Canadian study. Also information regarding specific treatment is not given. A search of the internet states that Herceptin was approved in Canada for early breast cancer in mid 2005. If so these number might have a large group of Her2 positive patients that did not receive Herceptin in the C2 group, 2004 - 2008. I would suspect that the current numbers are even better with adjuvant Herceptin for early stage.

With advances in treatment, such as neo-adjuvant Perjeta in the States - we are a group of women that are truly blessed with the results of cancer research.
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Old 05-20-2014, 08:29 PM   #3
Carol Ann
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Re: We've come a long way, Baby!

This is wonderful to see, 'Lizbeth, thanks so much for posting!

CA
__________________
July 24, 2013: "Infected" Right Nipple and benign cyst removed, pathology report revealed Paget's, DCIS, and ILC 1.25 cm, ER+/Pro+/HER2 equivocal, Grade 2 under benign cyst, previous diagnostic mammo/ultrasound said I was perfectly healthy in both breasts.

Aug 18, 2013: MRI report says Left breast is perfectly healthy "consistent with previous studies".

Sept 2013: I insist on a bilateral mastectomy anyway. Too nervewracking to let left breast remain with higher risk after 3 cancers in right, nipple in right is already gone anyhow.

Sept 18, 2013: Bilateral mastectomy, 11 right nodes removed, ALL negative BUT -- ER+/PRO+/HER2+ tumor, 1.0 cm, Grade 2 found in a piece of "grossly unremarkable" breast tissue from prophylactic mastectomy of left breast, no nodes removed.

Oct 25, 2013: 13 left side nodes removed, ALL negative, Stage 1 across the board, NO RADS needed, YAAAAY! Port also installed.

Nov 25, 2013 Begin 6 rounds TCH.

March 10, 2014 Just finished 6th and LAST Chemo today, YAAAAAY!

March 24, 2014 Echocardiogram to make sure I'm still good for Herceptin every 3 weeks.

March 31, 2014 Echo results NORMAL, first Herceptin all by itself. Now if only my eyes would stop streaming from the Taxotere ... :)

April 21, 2014 Started Arimidex and therapy for "mild" lymphedema in left hand and arm

May 2014 Therapy completed, I have sleeves and gloves for both arms, a Flexi touch lymph pump to hook up to for an hour every day, and I've become an arm bandaging expert. :)

June 2014 Begin Fosamax to prevent osteoporosis; bone scan revealed osteopenia

Nov 17, 2014 FINAL Herceptin!

Dec 4, 2014 My right thigh muscle has been extra achy for days ... I discover a blister rash cluster on the side of my right thigh while taking a shower. Port appointment cancelled until Dec 17, my doc is working me in tomorrow afternoon to see me and the rash. My muscle at least feels less achy.

Dec 5, 2014 Yep, I have shingles. Boo! I start acyclovir and also have a prescription for a painkiller just in case for over the weekend.

Dec 17, 2014 Port is OUT!

January 2016 Shingles again and this time it started where my left breast (where the hidden HER2+++ tumor was!) used to be. My onc nurse got me a same day appointment to see my doc when I called and told her I had a rash on the site. The antiviral meds are working once again, though, so that is good news. :)
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