title: Conditional disease-free survival among patients with breast cancer.
abstract: Conditional disease-free survival (CDFS) reflects changes over time. Because traditional disease-free survival (DFS) is estimated from the date of diagnosis, it is limited in the ability to predict risk of recurrence in patients who have been disease free. In this study, we determined CDFS of breast cancer patients and estimated the prognostic factors for DFS.We retrospectively reviewed clinical data of 7587 consecutive patients who underwent curative surgery for breast cancer between January 2004 and December 2013 at Samsung Medical Center. Univariate and multivariate analyses were performed to identify risk factors for DFS, which was computed using the Kaplan-Meier method. CDFS rates were based on cumulative DFS estimates.Median follow-up duration was 20.59 months. Three-year DFS was 93.46% at baseline. Three-year CDFS survival estimates for patients who had been disease free for 1, 2, 3, 4, and 5 years after treatment were calculated as 92.84%, 92.37%, 93.03%, 89.41%, and 79.64%, respectively. Three-year CDFS increased continuously each year after 1 year of DFS in hormone receptor (HR)-negative patients but decreased each year in HR-positive patients.In HR-positive patients who are disease free after 3 years, continuous care including surveillance and metastases workup should be considered, although this is not recommended in the current guidelines. On the other hand, the social costs may be reduced in HR-negative patients by extending the surveillance interval. Further studies are needed to identify indicators of DFS prognosis in breast cancer patients.
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center Department of Surgery, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyungkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyun-June
authors.initials: HJ
authors.lastname: Paik
authors.forename: Se Kyung
authors.initials: SK
authors.lastname: Lee
authors.forename: Jai Min
authors.initials: JM
authors.lastname: Ryu
authors.forename: Sungmin
authors.initials: S
authors.lastname: Park
authors.forename: Isaac
authors.initials: I
authors.lastname: Kim
authors.forename: Soo Youn
authors.initials: SY
authors.lastname: Bae
authors.forename: Jonghan
authors.initials: J
authors.lastname: Yu
authors.forename: Jeong Eon
authors.initials: JE
authors.lastname: Lee
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Nam
mesh_terms: D001808:Blood Vessels / Q000473:pathology; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry / Q000556:secondary* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology; D008875:Middle Aged; D008940:Mitotic Index; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human