Evidence map›Paper›PMID 36917303›Full record

ArticleBreast cancer research and treatment2023

Implications for surveillance for breast cancer patients based on the internally and externally validated BRENDA-metastatic recurrence score.

Florian Ebner, Jessica Salmen, Davut Dayan, Matthias Kiesel, Regine Wolters, Wolfgang Janni, Achim Wöckel, Manfred Wischnewsky

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Article in Breast cancer research and treatment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Florian EbnerUniversität Ulm, Prittwitzstr. 43, 890, Ulm, Germany. ebner@gyn-freising.de.ORCID http://orcid.org/0000-0003-2066-5344
Jessica SalmenUniversitätsfrauenklinik Würzburg, Würzburg, Germany.
Davut DayanUniversität Ulm, Prittwitzstr. 43, 890, Ulm, Germany.
Matthias KieselUniversitätsfrauenklinik Würzburg, Würzburg, Germany.
Regine WoltersFB Mathematik u. Informatik, Universität Bremen, Bibliothekar. 1, 28359, Bremen, Germany.
Wolfgang JanniUniversität Ulm, Prittwitzstr. 43, 890, Ulm, Germany.
Achim WöckelUniversitätsfrauenklinik Würzburg, Würzburg, Germany.
Manfred WischnewskyFB Mathematik u. Informatik, Universität Bremen, Bibliothekar. 1, 28359, Bremen, Germany.
Universität Ulm · DEUniversity of Bremen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAlthough the incidence of distant relapse is decreasing, 20-30% of patients with early breast cancer die of metastasis. The aim of this study is to characterize patients with metastasis-free survival(MFS) less than 5 years, to analyze the most probable site of metastases according to the internally and externally validated BRENDA-score. The BRENDA-score is a combination of the biological subtype and clinical staging.

method3832 patients with primary diagnosis of breast cancer and either distant metastatic recurrence within 5 years or MFS ≥ 5 years were assigned to this study. Patients were classified for metastatic recurrence according to the BRENDA-score. 1765 patients were in a validation set. Statistical methods were Kaplan-Meier curves, Cox regression analysis, Exhausted CHAID, likelihood-ratio tests and the Nearest Neighbor Estimation method.

resultsThere was a significant(p < 0.001) difference between the Kaplan-Meier MFS-functions of M0-patients stratified by BRENDA-score. The BRENDA score outperforms intrinsic subtypes and the Nottingham prognostic score. It fits the original data and the validation set equally well (p = 0.179).There was a significant(p < 0.001) difference between mean BRENDA-Index for patients with MFS < 5y(21.0 ± 9.0) and patients with MFS ≥ 5y(mean BRENDA-Index 11.7 ± 8.2). 55.6% of the very high risk patients(BRENDA-Index ≥ 27) had metastases within 5 years. The most likely primary metastatic site was bone(30%) followed by liver(19%) and lung(18%). The discriminatory ability(areas under the time dependent ROC curve) of the BRENDA score is good to acceptable for the first 5 years. In the very low/low risk (intermediate, high/very high) risk group 50% of all metastases were diagnosed within 26 months. Guideline adherence had a highly significant influence on outcome independent of the risk group.

conclusionThe evaluation showed that the BRENDA-Score is a robust predictive tool for breast cancer recurrence and site of metastases in the first five years after diagnosis. It outperforms intrinsic subtypes and the Nottingham prognostic score. The BRENDA-score could be a tool for a risk orientated and targeted follow up.

Indexed as

Breast NeoplasmsBreastFemaleHumansNeoplasm Recurrence, LocalNeoplasm StagingPrognosisRegression AnalysisRetrospective StudiesBreast cancerFollow upPredictionPrognosticRecurrence

Identifiers

PMID36917303
PMCPMC10147811
OpenAlexW4324128495

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