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Ten-Year Outcomes in a Population-Based Cohort of Node-Negative, Lymphatic, and Vascular Invasion–Negative Early Breast Cancers Without Adjuvant Systemic Therapies

From the Division of Medical Oncology, Breast Cancer Outcomes Unit, Division of Pathology and Division of Radiation Oncology, British Columbia Cancer Agency (BCCA), Vancouver and Victoria, Canada

Address reprint requests to Stephen Chia, MD, Division of Medical Oncology, British Columbia Cancer Agency, 600 West 10th Ave, Vancouver, BC Canada, V5Z 4E6; e-mail: schia{at}bccancer.bc.ca

PURPOSE: To discuss the absolute benefits from adjuvant systemic therapy knowledge of long-term outcomes and baseline risks of relapse and disease-specific survival are required. We assessed the 10-year outcomes in a population-based cohort of node-negative (N–) lymphovascular negative (LV–) early breast cancers diagnosed from 1989 to 1991 who did not receive adjuvant systemic therapy.

METHODS: One thousand one hundred eighty-seven cases of pT_1–2N₀ LV– breast cancers with a median follow-up of 10.4 years were reviewed. Kaplan-Meier survival curves for relapse free survival (RFS), breast cancer–specific survival (BCSS) and overall survival (OS) were compared with log-rank tests with cohorts stratified for tumor size and grade.

RESULTS: The median age of this series was 62 years. Four hundred thirty tumors were 1 cm in diameter (cohort 1), 507 were 1.1–2 cm (cohort 2), and 250 were 2.1 to 5 cm in diameter (cohort 3). The 10-year outcomes for cohorts 1, 2, and 3, respectively, were significantly different: RFS, 82%, 75%, and 66%; BCSS, 92%, 90%, and 77%; and OS, 79%, 78%, and 66%. Tumor grade significantly altered outcome within size cohorts, particularly in pT₁N₀ breast cancers.

CONCLUSION: This study provides detailed information on the continued relapse and breast cancer death rate to 10 years of follow-up. Specifically, without adjuvant systemic therapy, patients with LV–, N – breast cancer had a 25% 10-year risk of relapse and a corresponding 10-year breast cancer death rate of 10% if they had either a grade 3 tumor 1 cm, a grade 2 to 3 tumor from 1.1 to 2 cm, or any grade tumor greater than 2 cm.

Presented in part at the 39th American Society of Clinical Oncology Annual Meeting, May 18–21, 2002, Orlando, FL.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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