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. 2020 Jun;181(3):667-678.
doi: 10.1007/s10549-020-05600-x. Epub 2020 Apr 30.

Tumour characteristics and survivorship in a cohort of breast cancer: the MCC-Spain study

Inés Gómez-Acebo  1   2   3 , Trinidad Dierssen-Sotos  4   5 , Camilo Palazuelos-Calderón  5 , Beatriz Pérez-Gómez  4   6 , Pilar Amiano  7 , Marcela Guevara  4   8   9 , Antonio J Molina  10 , Laia Domingo  11   12 , María Fernández-Ortiz  5 , Victor Moreno  4   13   14   15 , Juan Alguacil  4   16 , Guillermo Fernández-Tardón  17 , Josefa Ibáñez  18   19 , Rafael Marcos-Gragera  4   20   21 , Marian Diaz-Santos  16 , M Henar Alonso  4   13   14   15 , Jessica Alonso-Molero  5 , Gemma Castaño-Vinyals  4   22   23   24 , Andrés García Palomo  25 , Eva Ardanaz  4   8   9 , Amaia Molinuevo  7 , Nuria Aragonés  4   26 , Manolis Kogevinas  4   22   23   24 , Marina Pollán  4   6 , Javier Llorca  4   5
Affiliations

Tumour characteristics and survivorship in a cohort of breast cancer: the MCC-Spain study

Inés Gómez-Acebo et al. Breast Cancer Res Treat. 2020 Jun.

Abstract

Purpose: The objective of this study is to analyse the relative survival with breast cancer in women diagnosed after new treatments were generalised and to ascertain the current effect that tumour characteristics such as grade, stage or subtype have on survival as well as the new AJCC-pathological prognostic score.

Methods: The breast cancer MCC-Spain follow-up study is a prospective cohort study of 1685 incident breast cancer cases. Women between 20 and 85 years old were recruited between the years 2008 and 2013 in 18 hospitals located in 10 Spanish provinces and they have been followed until 2017/2018. Relative survival was estimated after 3, 5 and 8 years of follow-up using Ederer II method. In addition, Weibull regression adjusted by age, hospital, grade and stage was used to investigate prognosis factors.

Results: Among components of TNM staging system, tumour size greater than 50 mm (i.e. T3 or T4) more than doubled the risk of dying, while N3 nodal involvement and presence of metastasis had a huge effect on mortality. The AJCC pathological prognostic score strongly correlated with survival; thus, hazard ratios increased as the score rose, being 2.31, 4.00, 4.94, 7.92, 2.26, 14.9 and 58.9 for scores IB, IIA, IIB, IIIA, IIIB, IIIC and IV, respectively.

Conclusion: Both TNM staging and histological/molecular biomarkers are associated with overall survival in Spanish women with breast cancer; when both are combined in the AJCC pathological prognosis score, the prognostic value improved with risk indices that increased rapidly as the pathological prognosis score increased.

Keywords: Breast cancer; Cohort; Epidemiology; MCC-spain; Relative survival.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Relative survival in Spanish women with breast cancer: a Overall survival, b survival according to TNM staging, c survival according to grading, d survival according to intrinsic subtype
Fig. 2
Fig. 2
Hazard ratios for overall survival showing the interaction between TNM stage and intrinsic subtype. a Hazard ratios for TNM stage stratified by intrinsic subtype, b hazard ratios for intrinsic subtype stratified by TNM stage
Fig. 3
Fig. 3
Kaplan–Meier survival estimates according to the AJCC pathological prognostic score
See this image and copyright information in PMC

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