title: Post-relapse survival in patients with the early and late distant recurrence in estrogen receptor-positive HER2-negative breast cancer.
abstract: BACKGROUND
  Few studies have been performed on post-relapse survival in patients with the early and late distant recurrence in estrogen receptor (ER)-positive, HER2-negative breast cancer.
  
  
  METHODS
  A total of 205 patients with the early distant recurrence and 134 patients with the late distant recurrence of ER-positive, HER2-negative breast cancer who had undergone breast surgery or neoadjuvant chemotherapy between January 2000 and December 2004 were registered from nine institutions. Prognostic factors for post-relapse survival in patients with the early and late recurrence were analyzed.
  
  
  RESULTS
  Post-relapse survival was significantly longer in patients with the late recurrence than in patients with the early recurrence. Predictive factors for post-relapse survival in patients with the early recurrence were lack of adjuvant chemotherapy, a long disease-free interval, and long durations of endocrine therapies and chemotherapies after relapse. In patients with the late recurrence, post-relapse survival was significantly improved for those individuals with one metastatic organ at relapse and individuals who were treated with the first-line and subsequent endocrine therapies for prolonged periods. Moreover, ER expression in primary breast tumors of late recurrence patients was significantly higher with a duration of the first-line endocrine therapy >6 months than in those with a duration ≤6 months.
  
  
  CONCLUSIONS
  Predictors for prognosis after relapse differed between patients with the early and late distant recurrence. Endocrine responsiveness after relapse is a key factor for improved post-relapse survival, and it is thus important to establish whether metastatic tumors are endocrine-resistant in ER-positive, HER2-negative recurrent breast cancer.
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 Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Kieko
authors.initials: K
authors.lastname: Yamazaki
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 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: 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: 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 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
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
mesh_terms: D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; C508053:ERBB2 protein, human
keywords: Breast cancer; Endocrine therapy; Estrogen receptor-positive; Post-relapse survival; Prognosis