Carvalho Giselle De Souza, Gomes Daniel Musse, Bretas Gustavo De Oliveira, Teixeira Victor Braga Gondim, Bines José
Clinical Research and Technological Development Division, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil.
Breast Cancer (Dove Med Press). 2025 Jul 28;17:683-691. doi: 10.2147/BCTT.S512760. eCollection 2025.
The current study aimed to assess the recurrence rate in hormone-receptor positive, HER2 negative (HR-positive/HER2-negative) breast cancer patients from a single center in Brazil and compare it with estimates provided by the Clinical Treatment Score post-five years (CTS5).
This study comprised a retrospective analysis of patients from a national cancer center database, which began treatment between 2007 and 2008 and had no evidence of recurrence after five years of follow-up. All patients had confirmed diagnosis of HR-positive/HER2-negative early breast cancer. Disease Free-Survival (DFS) according to each CTS5 risk subgroup was the main outcome.
A total of 162 patients were enrolled, 26.5% being premenopausal. The mean age at diagnosis was 60.1 years (49.8─71.6). Tumor stage: I (43.8%) and II (56.2%). Endocrine therapy consisted mainly of tamoxifen (88.0%). About 39.5%, 39.5%, and 21.0% of patients were in the low, intermediate, and high-risk (L/I/H) subgroups according to CTS5, respectively. Progesterone-receptor (PR) was ≥20% in 71.0% of tumors and 77.0%, 69.0%, and 65.0% in the L/I/H subgroups, respectively. The median follow-up was 88.9 months. DFS at 5 years (10 years since the beginning of endocrine therapy) was 100%, 96.3% (95% CI, 89.4%─100%) and 68.2% (95% CI, 48.7%─95.5%) in the L/I/H subgroups, respectively. PR was an independent prognostic factor for late recurrence in intermediate- (p=0.022) and high-risk (p=0.003) subgroup patients according to CTS5.
CTS5 performed well in the high-risk subset of patients from a wider population, including premenopausal women. The progesterone receptor was an independent prognostic factor for DFS in intermediate- and high-risk populations and should be further investigated in prospective multicenter studies.
本研究旨在评估巴西某单一中心激素受体阳性、人表皮生长因子受体2阴性（HR阳性/HER2阴性）乳腺癌患者的复发率，并将其与五年后临床治疗评分（CTS5）提供的估计值进行比较。
本研究对国家癌症中心数据库中的患者进行回顾性分析，这些患者于2007年至2008年开始治疗，随访五年后无复发证据。所有患者均确诊为HR阳性/HER2阴性早期乳腺癌。主要结局是根据每个CTS5风险亚组的无病生存期（DFS）。
共纳入162例患者，26.5%为绝经前患者。诊断时的平均年龄为60.1岁（49.8─71.6岁）。肿瘤分期：I期（43.8%）和II期（56.2%）。内分泌治疗主要包括他莫昔芬（88.0%）。根据CTS5，分别约39.5%、39.5%和21.0%的患者属于低、中、高风险（L/I/H）亚组。71.0%的肿瘤孕激素受体（PR）≥20%，L/I/H亚组中分别为77.0%、69.0%和65.0%。中位随访时间为88.9个月。L/I/H亚组5年（内分泌治疗开始后10年）的DFS分别为100%、96.3%（95%CI，89.4%─100%）和68.2%（95%CI，48.7%─95.5%）。根据CTS5，PR是中风险（p=0.022）和高风险（p=0.003）亚组患者晚期复发的独立预后因素。
CTS5在包括绝经前女性在内的更广泛人群的高风险亚组中表现良好。孕激素受体是中、高风险人群DFS的独立预后因素，应在前瞻性多中心研究中进一步研究。
