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New System Maps Out Odds of Breast Cancer Recurrence

Doctors, patients use website nomogram to calculate recurrence risk

Scientists in the Netherlands have developed a system that maps out the odds of local/regional recurrence of breast cancer in individual patients. On the basis of information about the patient, the original tumor, and the treatment used, they can accurately predict the odds of recurrence of breast cancer per year. The new system was described in Breast Cancer Research and Treatment.

On a website, doctors, together with their patients, can calculate the odds of recurrence of the disease.

Local/regional recurrence of breast cancer has a high risk of distant metastasis and a poor prognosis. Local/regional recurrence is defined as the reappearance of breast cancer at the same site as the primary tumor or as ipsilateral, infraclavicular, supraclavicular, or parasternal lymph nodes after curative treatment. In the Netherlands, patients are followed clinically for at least 5 years after their treatment. Still, most recurrences are detected by the patients themselves between follow-up visits, and some are detected after the 5 years of clinical follow-up.

Since 2012, oncologic guidelines in the Netherlands have advised doctors to follow an individualized approach in which the risk of cancer recurrence in a specific patient determines the follow-up course of action. In practice, however, this doesn’t usually happen because doctors don’t know the recurrence risk in individual patients.

Researchers at the University of Twente therefore developed a nomogram that doctors can use with patients to calculate the odds of recurrence of the disease. The system gives the odds of cancer recurrence per year, including the uncertainty of the prediction.

To develop their system, the researchers used information from approximately 40,000 breast cancer patients in the Netherlands Cancer Registry, a database in which information about the occurrence, survival, and deaths related to all types of cancer in the Netherlands has been recorded since 1989.

With this system, doctors have a tool they can use to help determine the best way to plan the follow-up for individual patients, the authors say. The university is now working on providing doctors with recommendations for planning subsequent check-ups.

According to surgeon Joost Klaase, who participated in the research, there is a clinical need for the system. “The nomogram for the risk of breast cancer recurrence gives us a tool to create a tailor-made follow-up for breast cancer patients; patients with a low risk of recurrence –– by far the largest group –– can be checked less often,” he said.

Sources: Medical Xpress; July 16, 2015; and Nomogram Questionnaire; 2015.

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