title: A risk score based on histopathological features predicts higher risk of distant recurrence in premenopausal patients with lymph node-negative endocrine-responsive breast cancer.
abstract: OBJECTIVE
  To develop a Risk Score (RS) to predict distant recurrence among premenopausal women with node-negative endocrine-responsive early breast cancer.
  
  
  METHODS
  The Cox model was used to develop the RS using clinical and histopathological features from 378 women participating in the IBCSG Trial VIII who received endocrine therapy alone or following chemotherapy. The performance of the resulting model was validated on a cohort of 1005 patients from a single institution who received endocrine therapy alone.
  
  
  RESULTS
  In a multivariable analysis, the risk of distant recurrence was associated with tumor size, ER, Ki-67 and peritumoral vascular invasion. In the validation cohort, patients with high RS were at greater risk of distant recurrence compared to patients with low RS (HR, 17.41; 95% CI, 5.72-52.95).
  
  
  CONCLUSIONS
  In premenopausal women with node-negative endocrine-responsive early breast cancer, the RS identifies patients at higher risk of distant recurrence.
authors: Medical Senology Research Unit & Division of Medical Oncology, Department of Medicine, European Institute of Oncology, Milan, Italy. silvia.dellapasqua@ieo.it
authors: Silvia
authors: S
authors: Dellapasqua
authors: Vincenzo
authors: V
authors: Bagnardi
authors: Meredith M
authors: MM
authors: Regan
authors: Nicole
authors: N
authors: Rotmensz
authors: Mauro G
authors: MG
authors: Mastropasqua
authors: Giuseppe
authors: G
authors: Viale
authors: Eugenio
authors: E
authors: Maiorano
authors: Karen N
authors: KN
authors: Price
authors: Richard D
authors: RD
authors: Gelber
authors: Monica
authors: M
authors: Castiglione-Gertsch
authors: Aron
authors: A
authors: Goldhirsch
authors: Marco
authors: M
authors: Colleoni
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000627:therapeutic use; D003661:Decision Support Techniques; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D017273:Goserelin / Q000008:administration & dosage; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D049451:Nomograms; D017697:Premenopause; D016032:Randomized Controlled Trials as Topic; D011960:Receptors, Estrogen / Q000378:metabolism; D018570:Risk Assessment; D016019:Survival Analysis; D013629:Tamoxifen / Q000008:administration & dosage; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D018931:Antineoplastic Agents, Hormonal; D019394:Ki-67 Antigen; D011960:Receptors, Estrogen; D013629:Tamoxifen; D017273:Goserelin; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate