Part of an oral presentation at the recent Society of Surgical Oncology’s 65th Annual Cancer Symposium in Orlando, revealed that a stratification of age, race and hormone receptor status helps to predict survival in node-negative breast cancer patients.

The study, which was a collaboration of researchers from The Cancer Institute of New Jersey (CINJ), UMDNJ-School of Public Health (SPH) and UMDNJ-Robert Wood Johnson Medical School, shows that the current breast cancer staging system in patients whose cancer has not spread to nearby lymph nodes (node-negative) can be improved by using this information, and that it may prove beneficial for clinicians to predict the outcomes for these patients more accurately.

The key predictive factor for women’s survival rates with local/regional breast cancer is lymph node staging. However, due to better screening methods, cancers are identified earlier and detection methods with diagnosing node-negative breast cancer become increasingly more common. To offer better counseling to women in terms of their prognosis, clinicians need a better risk prediction in node-negative breast cancer patients.

To evaluate the use of more detailed tumor information, in terms of the patient’s tumor size in relation to their age, their race and hormone receptor status, in order to improve the prognosis in women who are newly diagnosed with node-negative breast cancer, the researchers utilized Surveillance, Epidemiology, and End Results (SEER) data of 150,659 Caucasian, 15,849 Hispanic and 14,103 African-American women aged 18 years and older who had a node-negative, early-stage breast cancer diagnosis between 1994 and 2008.

All women underwent lumpectomy treatment that was followed by either radiation or mastectomy. The researchers assessed tumor sizes of 1mm increments for significant changes in survival in women who were categorized into 12 risk groups depending on age, race, receptor status and tumor grade, before determining the women’s cumulative 5-year survival estimates. Overall, for women with the same tumor size differences in survival were noted depending on their risk group.

The results for women above the age of 50 years between receptor negative and positive groups was similar to that of the women below the age of 50 years.

Leading researcher, Michelle Azu, MD, FACS, breast surgical oncologist at CINJ and assistant professor of surgery at UMDNJ-Robert Wood Johnson Medical School, who is also assistant professor of epidemiology at UMDNJ-SPH explained:

“Because of the continued advancements in the way we diagnose and treat breast cancer, it is imperative for healthcare professionals to have comprehensive information available to them when measuring prognosis.”

She concluded saying:

“By further exploring this area and determining why survival for a given tumor size differs by risk groups defined by age, race and receptor status, we will be able to provide better counsel to node-negative patients on their expected outcome. In terms of survival, one size does not fit all.”