An overview of prognostic factors for long-term survivors of breast cancer
- Isabelle SoerjomataramAffiliated withDepartment of Public Health, Erasmus MCComprehensive Cancer Centre South Email author
- , Marieke W. J. LouwmanAffiliated withComprehensive Cancer Centre South
- , Jacques G. RibotAffiliated withDepartment of Radiotherapy Catharina Hospital
- , Jan A. RoukemaAffiliated withDepartment of Surgery, St. Elisabeth Hospital
- , Jan Willem W. CoeberghAffiliated withDepartment of Public Health, Erasmus MCComprehensive Cancer Centre South
Numerous studies have examined prognostic factors for survival of breast cancer patients, but relatively few have dealt specifically with 10+-year survivors.
A review of the PubMed database from 1995 to 2006 was undertaken with the following inclusion criteria: median/mean follow-up time at least 10 years; overall survival and/or disease-specific survival known; and relative risk and statistical probability values reported. In addition, we used data from the long-standing Eindhoven Cancer Registry to illustrate survival probability as indicated by various prognostic factors.
10-year breast cancer survivors showed 90% 5-year relative survival. Tumor size, nodal status and grade remained the most important prognostic factors for long-term survival, although their role decreased over time. Most studies agreed on the long-term prognostic values of MI (mitotic index), LVI (lymphovascular invasion), Her2-positivity, gene profiling and comorbidity for either all or a subgroup of breast cancer patients (node-positive or negative). The roles of age, socioeconomic status, histological type, BRCA and p53 mutation were mixed, often decreasing after correction for stronger prognosticators, thus limiting their clinical value. Local and regional recurrence, metastases and second cancer may substantially impair long-term survival. Healthy lifestyle was consistently related to lower overall mortality.
Effects of traditional prognostic factors persist in the long term and more recent factors need further follow-up. The prognosis for breast cancer patients who have survived at least 10 years is favourable and increases over time. Improved long-term survival can be achieved by earlier detection, more effective modern therapy and healthier lifestyle.
KeywordsBreast cancer Long-term Prognostic factors Survival
- An overview of prognostic factors for long-term survivors of breast cancer
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Breast Cancer Research and Treatment
Volume 107, Issue 3 , pp 309-330
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- Breast cancer
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- Author Affiliations
- 1. Department of Public Health, Erasmus MC, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands
- 2. Comprehensive Cancer Centre South, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands
- 3. Department of Radiotherapy Catharina Hospital, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands
- 4. Department of Surgery, St. Elisabeth Hospital, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands