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. 2020 Sep 26;5(1):pkaa084.
doi: 10.1093/jncics/pkaa084. eCollection 2021 Feb.

Long-Term Prognostication for 20 114 Women With Small and Node-Negative Breast Cancer (T1abN0)

David Jaraj  1   2 , Jonas Höijer  3 , Linnea Widman  3 , Johan Ahlgren  4   5 , Lars-Gunnar Arnesson  6 , Zakaria Einbeigi  7   8 , Marie Klintman  9 , Eva Vikhe Patil  6 , Malin Sund  10 , Irma Fredriksson  11   12 , Jonas Bergh  12   13   1   4 , Pettersson Andreas  1
Affiliations

Long-Term Prognostication for 20 114 Women With Small and Node-Negative Breast Cancer (T1abN0)

David Jaraj et al. JNCI Cancer Spectr. .

Abstract

Background: Although small, node-negative breast cancer (ie, T1abN0) constitutes 20% of all newly diagnosed breast cancers, data on prognosis and prognostic factors are limited.

Methods: We conducted a population-based cohort study including 20 114 Swedish women treated for T1abN0 breast cancer from 1977 onward. Patient and tumor data were collected from Swedish breast cancer registries. Cohort subjects were followed through linkage to the Cause of Death Register. We calculated the cumulative incidence of breast cancer-specific and overall death and used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: During a median follow-up of 9.1 years (range = 0-38), 915 women died of breast cancer and 5416 of any cause. The 10-, 20-, and 30-year cumulative incidences of breast cancer death were 3.4% (95% CI = 3.1% to 3.7%), 7.6% (95% CI = 7.1% to 8.2%), and 10.5% (95% CI = 9.6% to 11.4%), respectively. The multivariable hazard ratios and 95% confidence intervals of breast cancer death were 0.92 (95% CI = 0.88 to 0.97) for each additional calendar year of diagnosis, 4.38 (95% CI = 2.79 to 6.87) for grade 3 vs grade 1 tumors, 0.43 (95% CI = 0.31 to 0.62) for progesterone receptor-positive vs progesterone receptor-negative disease, and 2.01 (95% CI = 0.99 to 4.07) for HER2-positive vs HER2-negative disease. Women with grade 3 vs grade 1 tumors had a 56% increased risk of death from any cause (HR = 1.56, 95% CI = 1.30 to 1.88).

Conclusions: The risk of breast cancer death in T1abN0 disease continues to increase steadily beyond 10 years after diagnosis, has improved over time, and varies substantially by tumor characteristics.

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Figures

Figure 1.
Figure 1.
Flow diagram describing the assembly of the study cohort.
Figure 2.
Figure 2.
Cumulative incidence of breast cancer death in women with T1abN0 breast cancer stratified by year of diagnosis.
Figure 3.
Figure 3.
Cumulative incidence of breast cancer death and death from any cause in women with T1abN0 breast cancer stratified by tumor grade. A) Cumulative incidence of breast cancer death and B) cumulative incidence of death by any cause are shown.
Figure 4.
Figure 4.
Cumulative incidence of death from breast cancer and death from any cause among women with T1abN0 breast cancer stratified by ER status. A) Cumulative incidence of breast cancer death and B) cumulative incidence of death by any cause are shown.
See this image and copyright information in PMC

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