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Individual risk profiling for breast cancer recurrence: towards tailored follow-up schemes.
Kraeima, J; Siesling, S; Vliegen, I M H; Klaase, J M; IJzerman, M J.
Affiliation
  • Kraeima J; Department of Health Technology and Service Research, MIRA institute for Biomedical Technology and Technical Medicine, University of Twente, PO Box 217, Enschede 7500 AE, The Netherlands.
Br J Cancer ; 109(4): 866-71, 2013 Aug 20.
Article in En | MEDLINE | ID: mdl-23860534
BACKGROUND: Breast cancer follow-up is not tailored to the risk of locoregional recurrences (LRRs) in individual patients or as a function of time. The objective of this study was to identify prognostic factors and to estimate individual and time-dependent LRR risk rates. METHODS: Prognostic factors for LRR were identified by a scoping literature review, expert consultation, and stepwise multivariate regression analysis based on 5 years of data from women diagnosed with breast cancer in the Netherlands in 2005 or 2006 (n=17,762). Inter-patient variability was elucidated by examples of 5-year risk profiles of average-, medium-, and high-risk patients, whereby 6-month interval risks were derived from regression estimates. RESULTS: Eight prognostic factors were identified: age, tumour size, multifocality, gradation, adjuvant chemo-, adjuvant radiation-, hormonal therapy, and triple-negative receptor status. Risk profiles of the low-, average-, and high-risk example patients showed non-uniform distribution of recurrence risks (2.9, 7.6, and 9.2%, respectively, over a 5-year period). CONCLUSION: Individual risk profiles differ substantially in subgroups of patients defined by prognostic factors for recurrence and over time as defined in 6-month time intervals. To tailor follow-up schedules and to optimise allocation of scarce resources, risk factors, frequency, and duration of follow-up should be taken into account.
Subject(s)

Full text: 1 Database: MEDLINE Main subject: Breast Neoplasms / Registries / Neoplasm Recurrence, Local / Neoplasms, Multiple Primary Type of study: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Female / Humans / Middle aged Language: En Journal: Br J Cancer Year: 2013 Type: Article Affiliation country: Netherlands

Full text: 1 Database: MEDLINE Main subject: Breast Neoplasms / Registries / Neoplasm Recurrence, Local / Neoplasms, Multiple Primary Type of study: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Limits: Female / Humans / Middle aged Language: En Journal: Br J Cancer Year: 2013 Type: Article Affiliation country: Netherlands