European Journal of Surgical Oncology
Volume 36, Issue 7 , Pages 617-624, July 2010

Tailored follow-up for early breast cancer patients: A prognostic index that predicts locoregional recurrence☆

  • J.G.H. van Nes

      Affiliations

    • Department of Surgery, Leiden University Medical Centre, K6-R, P.O. Box 9600, 2300 RC Leiden, The Netherlands
    • ,
  • H. Putter

      Affiliations

    • Department of Medical Statistics, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands
    • ,
  • M. van Hezewijk

      Affiliations

    • Department of Radiation Oncology, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands
    • ,
  • E.T.M. Hille

      Affiliations

    • Datacentre, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands
    • ,
  • H. Bartelink

      Affiliations

    • Department of Radiation Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
    • ,
  • L. Collette

      Affiliations

    • European Organisation of Cancer Research and Treatment, Avenue Mounierlaan 83/11, Brussel 1200, Belgium
    • ,
  • C.J.H. van de Velde

      Affiliations

    • Department of Surgery, Leiden University Medical Centre, K6-R, P.O. Box 9600, 2300 RC Leiden, The Netherlands
    • Corresponding Author InformationCorresponding author. Tel.: +31 71 526 2309; fax: +31 71 526 6750.
    • ,
  • on behalf of the EORTC Breast Cancer Group

      Affiliations

    • European Organisation of Cancer Research and Treatment, Avenue Mounierlaan 83/11, Brussel 1200, Belgium

Accepted 4 May 2010.

Abstract 

Aims

After treatment, early breast cancer patients undergo follow-up according to standard regimens. After the first year, the main goal is particularly to detect locoregional recurrences (LRR). Our aim was to develop a simple prognostic index to predict LRR to tailor the follow-up programme.

Methods

We used data from four large international clinical randomised trials and constructed the prognostic index using Cox proportional hazards regression. The bootstrap (a resampling method) was used for internal validation.

Results

A total of 6516 patients treated according to current guidelines with complete covariable information were used for analysis. Covariables important for LRR in patients treated with breast conserving therapy were age, pathological tumour status, boost and surgical margins. The same variables were important for patients treated with a mastectomy, however, instead of the boost, the pathological nodal status was important. The index is composed to consist of three groups based on LRR risk after 10-years.

Conclusions

We constructed a simple prognostic index that can be used to estimate risks of LRR in patients with early breast cancer. The prognostic index enables patients to be stratified into three subgroups with different outcomes with regard to LRR.

Keywords: Breast cancer, Locoregional recurrence, Prognostic index, Follow-up

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☆ Partly presented as poster presentation at the•13th Congress of the European Society of Surgical Oncology, 2006, Venice, Italy (best poster prize).•29th San Antonio Breast Cancer Symposium, 2006, San Antonio, Texas.

PII: S0748-7983(10)00118-6

doi:10.1016/j.ejso.2010.05.010

European Journal of Surgical Oncology
Volume 36, Issue 7 , Pages 617-624, July 2010

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