ArticleClinical cancer research : an official journal of the American Association for Cancer Research2025
Identification of Early-Stage Breast Cancer with a Minimal Risk of Recurrence by the Breast Cancer Index.
Article in Clinical cancer research : an official journal of the American Association for Cancer Research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Breast Cancer Index and Recommendations for Extended Endocrine Therapy.JAMA network open · 2026Observational
- Validation of minimal risk of recurrence classification by the Breast Cancer Index in early stage breast cancer.NPJ breast cancer · 2025Article
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14 authors.
Funding
Abstract
purposeThis study assessed the prognostic ability of the breast cancer index (BCI) to identify patients at a minimal risk (<5%) of 10-year distant recurrence (DR) who are unlikely to benefit from adjuvant endocrine therapy. EXPERIMENTAL
designThis prospective translational study included postmenopausal patients with early-stage, hormone receptor-positive N0 breast cancer from the Stockholm (STO-3) trial who underwent surgery alone ("untreated") or surgery plus adjuvant tamoxifen ("treated") and from the Netherlands Cancer Registry (surgery alone). The primary endpoint was time to DR. An adjusted BCI model with an additional cutpoint was developed, which stratified patients into four prognostic risk groups.
resultsAcross cohorts, 16% to 22% of patients were classified as minimal risk of 10-year DR. In the Stockholm untreated cohort (n = 283), risks in the minimal-, low-, intermediate-, and high-risk groups were 2.3%, 15.5% [hazard ratio, 4.71 (95% confidence interval, 1.09-20.29) vs. minimal risk], 19.8% [6.97 (1.61-30.18)], and 35.9% [13.21 (3.07-56.76)], respectively (P < 0.001). In the Stockholm treated cohort (n = 317), risks were 4.3%, 5.0% [1.16 (0.35-3.85)], 11.7% [2.45 (0.74-8.14)], and 21.1% [5.27 (1.72-16.16); P < 0.001]. In the Netherlands Cancer Registry cohort (n = 1245), risks were 4.5%, 7.5% [subdistribution hazard ratio, 1.67 (95% confidence interval, 0.81-3.45)], 10.3% [2.40 (1.14-5.03)], and 13.1% [3.13 (1.50-6.55); P = 0.005]. BCI risk scores provided additional independent information over standard prognostic factors (likelihood ratio, χ2 = 7.98; P = 0.004).
conclusionsThe adjusted BCI model identified women with early-stage, hormone receptor-positive N0 breast cancer at a minimal risk of DR who may consider de-escalating adjuvant endocrine therapy.
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