title: Clinicopathological factors predicting early and late distant recurrence in estrogen receptor-positive, HER2-negative breast cancer.
abstract: BACKGROUND
  Most studies analyzing prognostic factors for late relapse have been performed in postmenopausal women who received tamoxifen or aromatase inhibitors as adjuvant endocrine therapy for estrogen receptor (ER)-positive breast cancer.
  
  
  METHODS
  A total of 223 patients (108 premenopausal and 115 postmenopausal) with early distant recurrence and 149 patients (62 premenopausal and 87 postmenopausal) with late distant recurrence of ER-positive, HER2-negative breast cancer who were given their initial treatment between 2000 and 2004 were registered from nine institutions. For each late recurrence patient, approximately two matched control patients without relapse for more than 10 years were selected. Clinicopathological factors and adjuvant therapies were compared among the three groups by menopausal status and age.
  
  
  RESULTS
  Factors predicting early recurrence in premenopausal women were large tumor size, high lymph node category and high tumor grade, whereas predictors for late recurrence were large tumor size and high lymph node category. In postmenopausal women under 60 years of age, factors predicting early recurrence were bilateral breast cancer, large tumor size, high lymph node category, low PgR expression and high Ki67 labeling index (LI), while predictors for late recurrence were large tumor size and high lymph node category. On the other hand, in postmenopausal women aged 60 years or older, factors predicting early recurrence were bilateral breast cancer, large tumor size, high lymph node category, high tumor grade, low ER expression and high Ki67 LI, whereas predictors for late recurrence were high lymph node category, low ER expression and short duration of adjuvant endocrine therapy.
  
  
  CONCLUSIONS
  Predictors of early and late distant recurrence might differ according to menopausal status and age.
authors.affiliation: Breast Surgery, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648, Japan. hirokoy@huhp.hokudai.ac.jp.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Ogiya
authors.affiliation: Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Shien
authors.affiliation: Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Horimoto
authors.affiliation: Department of Surgery, Breast oncology, NHO Osaka National Hospital, Osaka, Japan.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Masuda
authors.affiliation: Department of Breast and Endocrine Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Touko
authors.initials: T
authors.lastname: Inao
authors.affiliation: Department of Breast and Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan.|Kumamoto Shinto General Hospital, Kumamoto, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Osako
authors.affiliation: Department of Breast Surgery, NHO Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Endo
authors.affiliation: Breast Surgery, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648, Japan.
authors.forename: Mitsuchika
authors.initials: M
authors.lastname: Hosoda
authors.affiliation: Breast Surgery, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Ishida
authors.affiliation: Division of Pathology, Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Horii
authors.affiliation: Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Kieko
authors.initials: K
authors.lastname: Yamazaki
authors.affiliation: Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Miyoshi
authors.affiliation: Department of Surgery, Breast oncology, NHO Osaka National Hospital, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yasojima
authors.affiliation: Department of Breast Surgery, NHO Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Nobumoto
authors.initials: N
authors.lastname: Tomioka
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology* / Q000628:therapy; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis / Q000378:metabolism; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology; D017698:Postmenopause; D017697:Premenopause; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: Breast cancer; Early recurrence; Estrogen receptor positive; HER2 negative; Late recurrence