. 2004 Nov;9(6).
doi: 10.1634/theoncologist.9-6-606.

Prognostic and predictive factors in early-stage breast cancer

Mary Cianfrocca 1 Lori J Goldstein  
  • PMID: 15561805
  •     175 citations


Breast cancer is the most common malignancy among American women. Due to increased screening, the majority of patients present with early-stage breast cancer. The Oxford Overview Analysis demonstrates that adjuvant hormonal therapy and polychemotherapy reduce the risk of recurrence and death from breast cancer. Adjuvant systemic therapy, however, has associated risks and it would be useful to be able to optimally select patients most likely to benefit. The purpose of adjuvant systemic therapy is to eradicate distant micrometastatic deposits. It is essential therefore to be able to estimate an individual patient's risk of harboring clinically silent micrometastatic disease using established prognostic factors. It is also beneficial to be able to select the optimal adjuvant therapy for an individual patient based on established predictive factors. It is standard practice to administer systemic therapy to all patients with lymph node-positive disease. However, there are clearly differences among node-positive women that may warrant a more aggressive therapeutic approach. Furthermore, there are many node-negative women who would also benefit from adjuvant systemic therapy. Prognostic factors therefore must be differentiated from predictive factors. A prognostic factor is any measurement available at the time of surgery that correlates with disease-free or overall survival in the absence of systemic adjuvant therapy and, as a result, is able to correlate with the natural history of the disease. In contrast, a predictive factor is any measurement associated with response to a given therapy. Some factors, such as hormone receptors and HER2/neu overexpression, are both prognostic and predictive.

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Mod Pathol, 2017 May 27; 30(8). PMID: 28548119
Interaction of mammographic breast density with menopausal status and postmenopausal hormone use in relation to the risk of aggressive breast cancer subtypes.
Lusine Yaghjyan, Rulla M Tamimi, +15 authors, Celine M Vachon.
Breast Cancer Res Treat, 2017 Jun 19; 165(2). PMID: 28624977    Free PMC article.
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Ishita Gupta, Ikram Burney, Mansour S Al-Moundhri, Yahya Tamimi.
Mol Clin Oncol, 2017 Jul 08; 7(1). PMID: 28685067    Free PMC article.
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Br J Surg, 2017 Jul 19; 104(11). PMID: 28718896    Free PMC article.
Percentage change of primary tumor on 18F-FDG PET/CT as a prognostic factor for invasive ductal breast cancer with axillary lymph node metastasis: Comparison with MRI.
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Medicine (Baltimore), 2017 Aug 03; 96(31). PMID: 28767583    Free PMC article.
Lymph node status have a prognostic impact in breast cancer patients with distant metastasis.
Chuangang Tang, Pei Wang, +4 authors, Changwen Li.
PLoS One, 2017 Aug 15; 12(8). PMID: 28806399    Free PMC article.
Increased risk of recurrence associated with certain risk factors in breast cancer patients after DIEP-flap reconstruction and lipofilling-a matched cohort study with 200 patients.
Sonia Fertsch, Mazen Hagouan, +7 authors, Oliver Christian Thamm.
Gland Surg, 2017 Sep 02; 6(4). PMID: 28861370    Free PMC article.
Relationship Between PD-L1 Expression and Clinical Characteristics in Patients with Breast Invasive Ductal Carcinoma.
Jian Lou, Yuefen Zhou, Jianhui Huang, Xiaojun Qian.
Open Med (Wars), 2017 Sep 13; 12. PMID: 28894845    Free PMC article.
Multi-center study on patient selection for and the oncologic safety of intraoperative radiotherapy (IORT) with the Xoft Axxent® eBx® System for the management of early stage breast cancer in Taiwan.
Hung-Wen Lai, Liang-Chih Liu, +14 authors, Fang-Ming Chen.
PLoS One, 2017 Nov 03; 12(11). PMID: 29095832    Free PMC article.
Triptorelin: A Review of its Use as an Adjuvant Anticancer Therapy in Early Breast Cancer.
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Decreased expression of CADM1 and CADM4 are associated with advanced stage breast cancer.
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Oncol Lett, 2018 Feb 13; 15(2). PMID: 29434950    Free PMC article.
A hierarchical prognostic model for risk stratification in patients with early breast cancer according to 18 F-fludeoxyglucose uptake and clinicopathological parameters.
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Cancer Med, 2018 Feb 27; 7(4). PMID: 29479851    Free PMC article.
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Contemp Clin Trials Commun, 2016 Mar 31; 3. PMID: 29736456    Free PMC article.
Axillary ultrasound and fine needle aspiration biopsy in the preoperative diagnosis of axillary metastases in early-stage breast cancer.
Xin Hu, Xiao Zhou, +3 authors, Jianlun Liu.
Oncol Lett, 2018 May 29; 15(6). PMID: 29805585    Free PMC article.
The association between Notch4 expression, and clinicopathological characteristics and clinical outcomes in patients with breast cancer.
Jing-Wei Wang, Xiao-Long Wei, +3 authors, Guo-Jun Zhang.
Oncol Lett, 2018 May 29; 15(6). PMID: 29805613    Free PMC article.
CXCR4/CXCL12 Signaling and Protumor Macrophages in Primary Tumors and Sentinel Lymph Nodes Are Involved in Luminal B Breast Cancer Progression.
Carlotta Raschioni, Giulia Bottai, +8 authors, Luca Di Tommaso.
Dis Markers, 2018 Jun 01; 2018. PMID: 29849822    Free PMC article.
Treatment patterns for adjuvant docetaxel-based chemotherapy in early-stage breast cancer in China: A pooled retrospective analysis of four observational studies.
Binghe Xu, Zhimin Shao, +7 authors, Shu Wang.
Chin J Cancer Res, 2018 Jul 27; 30(3). PMID: 30046227    Free PMC article.
Associations of angiogenesis-related proteins with specific prognostic factors, breast cancer subtypes and survival outcome in early-stage breast cancer patients. A Hellenic Cooperative Oncology Group (HeCOG) trial.
Anna Goussia, Nafsika Simou, +24 authors, Anna Batistatou.
PLoS One, 2018 Aug 01; 13(7). PMID: 30063723    Free PMC article.
Associations between obesity, smoking and lymph node status at breast cancer diagnosis in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial.
Amelia Smith, Maeve Mullooly, +2 authors, Kathleen Bennett.
PLoS One, 2018 Aug 30; 13(8). PMID: 30157224    Free PMC article.
Is postmastectomy radiotherapy really needed in breast cancer patients with many positive axillary lymph nodes?
Tanja Marinko, Karmen Stanic.
Radiol Oncol, 2018 Sep 14; 52(3). PMID: 30210045    Free PMC article.
Oncological safety of autologous breast reconstruction after mastectomy for invasive breast cancer.
Joachim Geers, Hans Wildiers, +6 authors, Ann Smeets.
BMC Cancer, 2018 Oct 21; 18(1). PMID: 30340548    Free PMC article.
Predicting the response to neoadjuvant therapy for early-stage breast cancer: tumor-, blood-, and imaging-related biomarkers.
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Cancer Manag Res, 2018 Oct 24; 10. PMID: 30349367    Free PMC article.
Dosimetric evaluation and systematic review of radiation therapy techniques for early stage node-negative breast cancer treatment.
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Cancer Manag Res, 2018 Nov 15; 10. PMID: 30425577    Free PMC article.
Machine Learning With K-Means Dimensional Reduction for Predicting Survival Outcomes in Patients With Breast Cancer.
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Cancer Inform, 2018 Nov 21; 17. PMID: 30455569    Free PMC article.
CDK4/6 inhibition in low burden and extensive metastatic breast cancer: summary of an ESMO Open-Cancer Horizons pro and con discussion.
Ahmad Awada, Joseph Gligorov, +3 authors, Christoph Zielinski.
ESMO Open, 2019 Dec 05; 4(6). PMID: 31798979    Free PMC article.
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J Biomed Opt, 2019 Sep 15; 24(9). PMID: 31520468    Free PMC article.
SLX4IP and telomere dynamics dictate breast cancer metastasis and therapeutic responsiveness.
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Life Sci Alliance, 2020 Feb 20; 3(4). PMID: 32071280    Free PMC article.
MAGI1, a New Potential Tumor Suppressor Gene in Estrogen Receptor Positive Breast Cancer.
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Cancers (Basel), 2020 Jan 23; 12(1). PMID: 31963297    Free PMC article.
Association of white blood cell count with breast cancer burden varies according to menopausal status, body mass index, and hormone receptor status: a case-control study.
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Sci Rep, 2019 Apr 10; 9(1). PMID: 30962496    Free PMC article.
Prognostic Significance of Metabolic Parameters and Textural Features on 18F-FDG PET/CT in Invasive Ductal Carcinoma of Breast.
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Sci Rep, 2019 Jul 31; 9(1). PMID: 31358786    Free PMC article.
Metabolic Pathway Analysis and Effectiveness of Tamoxifen in Danish Breast Cancer Patients.
Thomas P Ahern, Lindsay J Collin, +16 authors, Deirdre Cronin-Fenton.
Cancer Epidemiol Biomarkers Prev, 2020 Jan 15; 29(3). PMID: 31932415    Free PMC article.
p53 Loss in Breast Cancer Leads to Myc Activation, Increased Cell Plasticity, and Expression of a Mitotic Signature with Prognostic Value.
Angela Santoro, Thalia Vlachou, +16 authors, Pier Giuseppe Pelicci.
Cell Rep, 2019 Jan 17; 26(3). PMID: 30650356    Free PMC article.
Clinical validation of an immunohistochemistry-based CanAssist-Breast test for distant recurrence prediction in hormone receptor-positive breast cancer patients.
Manjiri M Bakre, Charusheila Ramkumar, +10 authors, Mark D Pegram.
Cancer Med, 2019 Mar 09; 8(4). PMID: 30848103    Free PMC article.
Trastuzumab plus adjuvant chemotherapy for human epidermal growth factor receptor 2 (HER2)-positive early-stage breast cancer: A real-world retrospective study in Chinese patients.
Jihong Guo, Qing Li, +8 authors, Binghe Xu.
Chin J Cancer Res, 2019 Dec 10; 31(5). PMID: 31814680    Free PMC article.
Evaluation of long-chain acyl-coenzyme A synthetase 4 (ACSL4) expression in human breast cancer.
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Res Pharm Sci, 2020 Mar 18; 15(1). PMID: 32180816    Free PMC article.
Impact of Obesity on Clinicopathologic Characteristics and Disease Prognosis in Pre- and Postmenopausal Breast Cancer Patients: A Retrospective Institutional Study.
Nehad M Ayoub, Rami J Yaghan, +3 authors, Alia H Al-Mohtaseb.
J Obes, 2019 Apr 26; 2019. PMID: 31019808    Free PMC article.
Long-term survival outcomes in invasive lobular carcinoma patients with and without preoperative MR imaging: a matched cohort study.
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Eur Radiol, 2019 Jan 09; 29(5). PMID: 30617471
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J Cancer Metastasis Treat, 2019 Aug 24; 5. PMID: 31440584    Free PMC article.
A multi-institutional real world data study from India of 3453 non-metastatic breast cancer patients undergoing upfront surgery.
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Sci Rep, 2020 Apr 05; 10(1). PMID: 32246015    Free PMC article.
Clinical association of progesterone receptor isoform A with breast cancer metastasis consistent with its unique mechanistic role in preclinical models.
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BMC Cancer, 2020 Jun 05; 20(1). PMID: 32493230    Free PMC article.
Candidate methylation sites associated with endocrine therapy resistance in ER+/HER2- breast cancer.
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BMC Cancer, 2020 Jul 21; 20(1). PMID: 32684154    Free PMC article.
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Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast Cancer.
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BCL-2 expression aids in the immunohistochemical prediction of the Oncotype DX breast cancer recurrence score.
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Mol Clin Oncol, 2019 Jan 19; 10(1). PMID: 30655995    Free PMC article.
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Long-Term Use of Tamoxifen Is Associated With a Decreased Subsequent Meningioma Risk in Patients With Breast Cancer: A Nationwide Population-Based Cohort Study.
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Genome-wide analysis of therapeutic response uncovers molecular pathways governing tamoxifen resistance in ER+ breast cancer.
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Front Oncol, 2020 Nov 17; 10. PMID: 33194714    Free PMC article.
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Health Place, 2020 Jun 17; 63. PMID: 32543424    Free PMC article.
Perfusion contrast-enhanced ultrasound to predict early lymph-node metastasis in breast cancer.
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Prognostic models for breast cancer: a systematic review.
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BMC Cancer, 2019 Mar 16; 19(1). PMID: 30871490    Free PMC article.
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Mol Med Rep, 2019 Mar 22; 19(5). PMID: 30896800    Free PMC article.
Locally advanced breast cancer treated with neoadjuvant chemotherapy and adjuvant radiotherapy: a retrospective cohort analysis.
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BMC Cancer, 2019 Apr 05; 19(1). PMID: 30943923    Free PMC article.
Pharmacogenomics, CYP2D6, and Tamoxifen: A Survey of the Reasons Sustaining European Clinical Practice Paradigms.
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Medicina (Kaunas), 2019 Jul 10; 55(7). PMID: 31284530    Free PMC article.
A multiple breast cancer stem cell model to predict recurrence of T1-3, N0 breast cancer.
Yan Qiu, Liya Wang, +8 authors, Hong Bu.
BMC Cancer, 2019 Jul 26; 19(1). PMID: 31340763    Free PMC article.
PLC-gamma-1 phosphorylation status is prognostic of metastatic risk in patients with early-stage Luminal-A and -B breast cancer subtypes.
Rossano Lattanzio, Manuela Iezzi, +8 authors, Mauro Piantelli.
BMC Cancer, 2019 Aug 01; 19(1). PMID: 31362705    Free PMC article.
To Evaluate the Accuracy of Axillary Staging Using Ultrasound and Ultrasound-Guided Fine-Needle Aspiration Cytology (USG-FNAC) in Early Breast Cancer Patients-a Prospective Study.
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Radiomics Nomogram of DCE-MRI for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer.
Ning Mao, Yi Dai, +5 authors, Nan Hong.
Front Oncol, 2021 Jan 01; 10. PMID: 33381444    Free PMC article.
Evaluation of glucocorticoid-induced TNF receptor (GITR) expression in breast cancer and across multiple tumor types.
Mayanne M T Zhu, Samantha Burugu, +5 authors, Torsten O Nielsen.
Mod Pathol, 2020 May 01; 33(9). PMID: 32350416
Targeting the purinergic pathway in breast cancer and its therapeutic applications.
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Prognostic value of p53 expression in hormone receptor-positive and human epidermal growth factor receptor 2-negative breast cancer patients receiving neoadjuvant chemotherapy.
Loai Saleh Albinsaad, Jisun Kim, +6 authors, Sae Byul Lee.
Breast Cancer Res Treat, 2021 Feb 19;. PMID: 33599867
Large Tumor Size is an Indicator for the Timely Administration of Adjuvant Radiotherapy in Luminal Breast Cancer with Positive Lymph Node.
Kai-Yun You, Wei-Liang Zou, +2 authors, He-Rui Yao.
Cancer Manag Res, 2021 Feb 20; 13. PMID: 33603478    Free PMC article.