Breast Cancer in Young Women by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030247621
Publisher: Springer International Publishing

Low-risk

pT1a-b, pN0, G1 and/or low Ki67 (≤20%), high receptors

Intermediate-risk

pT1c-pT2, pN1a, G1-2 and/or intermediate Ki67 (20–30%), high-intermediate receptors

High-risk

pT3-pT4, pN2-pN3, G3 and/or high Ki67 (>30%), intermediate to low receptors

11.2 Patients at Low-Risk of Relapse

Tamoxifen alone is still considered the standard of care in patients at low-risk of relapse (Table 11.1). In the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) 2011 meta-analysis [11], 5 years of tamoxifen compared to no ET was associated with an absolute 15-year risk reduction of 13.2% in breast cancer recurrence and of 9.2% in breast cancer mortality, regardless of age, the use of chemotherapy, and nodal status. The 5-year results of the SOFT trial [16] (n = 3066) showed that escalating ET by adding OFS to tamoxifen did not provide a significant benefit in the overall study population. In particular, among low-risk patients, in whom chemotherapy was not deemed indicated, the 5-year BCFI was >95% with either treatment, with few distant recurrences. The updated results, after a median follow-up of 8 years, show, in the overall population, a significant 4.4% absolute improvement in disease-free survival (DFS) by the addition of OFS to tamoxifen (83.2% versus 78.8%, hazard ratio (HR) 0.76; 95% CI, 0.62 to 0.93; P = 0.009) [21]. Among low-risk HER2- patients who did not receive chemotherapy, the absolute improvements in disease outcomes are summarized in Table 11.2. In particular, the BCFI was improved by 1.3% in patients receiving tamoxifen-OFS compared to tamoxifen alone (93.3% and 92.0%, respectively). There have been few distant recurrences in these low-risk patients and >98% were alive in each treatment group (Figs. 11.2 and 11.3).Table 11.28-year absolute disease improvements in SOFT low-risk HER2 patients

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