MONDAY, Sept. 29 (HealthDay News) -- A model based on tumor characteristics after endocrine therapy can predict survival in women with breast cancer and help individualize treatment, according to a report published in the Oct. 1 issue of the Journal of the National Cancer Institute.
Matthew J. Ellis, Ph.D., from Washington University School of Medicine in St. Louis, and colleagues examined factors associated with survival in 158 postmenopausal women with estrogen receptor-positive stage 2 and 3 breast cancers who had been treated with letrozole or tamoxifen before surgery. The mean follow-up was 61.2 months.
The researchers found that women whose tumors were downgraded to stage 0 or 1 at surgery had 100 percent relapse-free survival. Tumor size, node status, estrogen receptor status and levels of the proliferative marker Ki67 were all independently associated with relapse-free and breast cancer-specific survival. The data were used to develop a preoperative endocrine prognostic index (PEPI), which predicted relapse-free survival in an independent set of 203 women previously treated in another trial.
"Breast cancer patients with pathological stage 1 or 0 disease after neoadjuvant endocrine therapy and a low-risk biomarker profile in the surgical specimen (PEPI score 0) have an extremely low risk of relapse and are therefore unlikely to benefit from adjuvant chemotherapy," Ellis and colleagues conclude.
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