Similarly, a portion of women with “triple-negative” breast cancer remained at high risk of recurrence over 20 years. Triple-negative cancer has no receptors for estrogen, HER2 or the hormone progesterone — and most recurrences happen within the first five years.
Dr. Harold Burstein is a medical oncologist at Dana-Farber Cancer Institute in Boston. He said the new findings could “open a door” toward better-tailoring patients’ treatment.
“This study points the way toward understanding, with far more detail, what patients can expect as far as their risk of recurrence,” said Burstein, who was not involved in the study.
He cautioned, however, that this is not something patients can ask their doctors about tomorrow. More research is needed before the findings can be translated into a test for use in everyday practice, Burstein said.
The hope, Curtis said, is that when patients are diagnosed with breast cancer, doctors will be able to analyze their tumor for molecular red flags — and then “stratify them upfront.”
If a woman has a cancer that’s likely to come back down the road, that might change her treatment.
Burstein pointed to an example: Hormone therapy, with drugs that block estrogen’s effects, is a standard treatment for ER-positive cancer. But, he said, there’s “controversy” over how long that treatment should last.
If doctors could better predict which patients had a high recurrence risk, those women might want to continue hormone therapy past the standard five years.
At this point, though, it’s not known whether such a treatment tactic would change the long-term outlook for those patients, said Dr. George Plitas, a breast cancer surgeon at Memorial Sloan Kettering Cancer Center in New York City.
“How would this be incorporated into clinical practice? It’s unclear right now,” Plitas said.
That said, he pointed to another contribution of the new findings. They give insight into the biology that helps determine whether a woman will have a recurrence years later. And that could help researchers develop new treatment approaches for those patients.
“This identifies potential molecular pathways for intervention,” said Plitas, who played no role in the research.