Stage I Breast Cancer in the Modern Era: A Retrospective Cohort Study of 328 Patients Diagnosed from 2002 to 2006 with a 14-Year Median Follow-Up

Maayan Hadar, Michael Friger, Samuel Ariad, Michael Koretz, Bertha Delgado, Margarita Tokar, Michael Bayme, Ravit Agassi, Maia Rosenthal, Victor Dyomin, Olga Belochitski, Noa Amir, Shai Libson, Amichay Meirovitz, Irena Lazarev, Sara Abu-Ghanem, David B. Geffen

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: This study aimed to evaluate the long-term outcomes of stage I breast cancer (BC) patients diagnosed during the current era of screening mammography, immunohistochemistry receptor testing, and systemic adjuvant therapy. Methods: A retrospective cohort studywas conducted on 328 stage I BC patients treated consecutively in a single referral center with a follow-up period of at least 12 years. The primary endpoints were invasive disease-free survival (IDFS) and overall survival (OS). The influence of tumor size, grade, and subtype on the outcomes was analyzed. Results: Most patients were treated by lumpectomy, sentinel node biopsy, and adjuvant endocrine therapy, and most (82%) were of subtype luminal A. Adjuvant chemotherapy was administered to 25.6% of our cohort. Only 24 patients underwent gene expression testing, which was introduced toward the end of the study period. Mean IDFS was 14.64 years, with a 15-year IDFS of 75.6%. Mean OS was 15.28 years with a 15-year OS of 74.9%. In a Cox multivariate analysis, no clinical or pathologic variable impacted on OS and only tumor size (<1 cm vs. 1-2 cm) impacted significantly on IDFS. During follow-up, 20.1% of the cohort developed second primary cancers, including BC. The median time to diagnosis of a second BC was 6.49 years. Conclusion: The study results emphasize the importance of long-term follow-up and screening for subsequent malignancies of patients with stage I BC and support the need for using prognostic and predictive indicators beyond the routine clinicopathological characteristics in luminal A patients.

Original languageEnglish
JournalOncology
DOIs
StateAccepted/In press - 1 Jan 2024

Keywords

  • Long-term follow-up
  • Real world
  • Second primary
  • Stage I breast cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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