BACKGROUND AND PURPOSE:

• In recent decades, more effective breast cancer treatments have become available, leading to an increase in the prevalence of long-term survivors
• Approximately 50% of women with early stage breast cancer remain disease-free for at least ten years
• Pedersen et al. (Journal of the National Cancer Institute, 2021) examined the risk of late breast cancer recurrence up to 32 years later

METHODS:

• Nationwide cohort study
  • Data derived from Danish administrative and population-based registries
• Population
  • All women with incident early breast cancer diagnosed during 1987 to 2004
  • 10 years without a recurrence or second cancer
• Exposures
  • Patient and tumor characteristics
• Study design
  • 10-year disease-free survivors were followed from 10 years after breast cancer diagnosis until late recurrence, death, emigration, second cancer, or December 2018
  • Late breast cancer recurrence was calculated as incidence rates per 1000 person-years and cumulative incidences
  • Adjusted hazard ratio (HR) was calculated using Cox regression
• Primary outcome
  • Late breast cancer recurrence

RESULTS:

• 36,924 women with breast cancer between 1987 and 2004
  • 10-year disease-free survivors: 20,315 women
• Incidence of late breast cancer recurrence 10 to 32 years after primary diagnosis
  • Total late recurrence cases: 2595 women
  • Incidence rate 15.53 per 1000 person-years (95% CI, 14.94 to 16.14)
  • Cumulative incidence 16.6% (95% CI, 15.8 to 17.5)
• The following were associated with increased cumulative incidences and hazards for late breast cancer recurrence
  • Tumor size >20 mm
  • Lymph node positive disease
  • Estrogen receptor-positive tumors

CONCLUSION:

• Late breast cancer recurrence in 10-year disease-free survivors occurred in 16.6% of women 10 to 32 years after primary diagnosis
• Women who had larger tumors, estrogen-receptor positive tumors, and lymph node involvement were at increased risk
• The authors state

Our findings suggest that a subset of patients—with larger tumors, positive lymph nodes, or ER-positive disease—are at risk of late recurrence

Such patients may warrant extended surveillance, more aggressive treatment, or new therapies

Our study advocates for further research to characterize the biology underlying the resurgence of breast cancer long after primary diagnosis to inform strategies for prevention, treatment, and effective follow-up programs

Learn More – Primary Sources:

The Incidence of Breast Cancer Recurrence 10-32 Years after Primary Diagnosis

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