Hazard of Recurrence among Women after Primary Breast Cancer Treatment - A 10-Year Follow-Up Using Data from SEER-Medicare
A partir de données des registres américains du cancer et de la base Medicare portant sur 20 027 femmes, cette étude analyse le taux de récidive de cancer du sein chez des patientes ayant terminé complètement leur premier traitement (durée de suivi 10 ans)
Few studies have used SEER-Medicare data to describe recurrence of breast cancer after completion of primary treatment for US women. Methods We used SEER-Medicare data to estimate the annual hazard rate (HR) of recurrence for women with breast cancer between 1991 and 1997 with 10 years of follow-up. The Kaplan-Meier method was used to derive the HR. Multivariate Cox proportional hazards model was used to estimate the relative hazard of the recurrence associated prognostic factors. Results Of 20,027 women, 36.8% had recurrence within 10 years, with most of these recurrences (81.9%) occurring within 5 years after diagnosis. Women with stage III cancer showed the highest HR peak and largest magnitude compared with women with stage I or II disease (both P<0.01) within the first 5 years. Women with negative tumor hormone receptor status had a higher peak hazard of developing recurrence within the first 5 years (P<0.01), but the hazards were remarkably lower beyond 5 years of follow-up compared with women with positive or unknown hormone-receptor status (P>0.05). Women with poorly differentiated histological grade tumors showed higher HR in the first 5 years than women with other grades after primary treatment (both P<0.01). The increased risk of recurrence of breast cancer was associated with advanced stage, moderate and poorly differently grades, and negative hormone receptor status (all P < 0.01). Conclusion The HRs of the recurrence are dynamic over 10 years and are markedly determined by prognostic factors at diagnosis, suggesting that the optimal follow-up may differ among women.