Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
Clinical and pathologic insights into early and late breast cancer relapses: a real-world analysis from the El Álamo IV registry.
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Fraile-Lara Lucía, Andrés Raquel, Servitja Sonia, Carrasco Eva, Guerrero Ángel, Bermejo Begoña, Antón Antonio, Cruz Josefina, Álvarez Isabel, Aguiar David, Martínez Purificación, Rodríguez-Lescure Álvaro, Blasco Andrea, Martín Miguel, López-Tarruella Sara
Аннотация
BACKGROUND: Finding prognostic factors for early and late relapses in operable breast cancer (BC) could improve relapse risk stratification; but there is a lack of real-world data with long enough follow-up.
OBJECTIVE: To investigate clinical and pathological features related to early versus late relapses in a real-world cohort of BC patients.
METHODS: To identify factors related to early (≤ 2 years) and late (≥ 5 years) relapse in women with stage I-III BC, hormone receptor (HR)-positive and human epidermal growth factor receptor 2-negative (HER2-), and HR-negative (HR -)/HER2 - by immunohistochemistry from El Álamo IV registry, logistic regression model was performed. To explore relapse dynamics, multivariate Cox regression models and annual hazard rates of relapses were reported.
RESULTS: Of the 1493 relapses, early, intermediate, and late relapses represented 28.3%, 29.7%, and 42.1% of all relapses, respectively. In 1050 patients, of both early and late relapses, age > 70 years (odds ratio [OR] 5.13; 95% confidence interval [CI] 3.23-8.15), stage III (OR 3.22; 95% CI 1.90-5.46), histological grade 3 (OR, 2.93; 95% CI 1.69-5.10), and HR - /HER2 - subtype (OR 10.26; 95% CI 6.55-16.05) were associated with an increase of early relapse risk. Annual hazard rate of loco-regional relapses (LRR) steadily increased over time in patients with HR + /HER2 - tumors, while those with HR - /HER2 - tumors exhibited a fluctuating pattern. For distant relapses (DR), the hazard rate peaked at 2 years and then rise steadily in HR + /HER2 - tumors whereas remained variable in HR - /HER2 - tumors. In multivariate Cox model, LRR was associated with stage, subtype, and histological grade, while DR was additionally influenced by age.
CONCLUSION: Age at diagnosis, stage, histological grade, and tumor subtype were associated with distinct relapse timing patterns. These findings support further research into relapse dynamics and predictors by analyzing real-world data.
OBJECTIVE: To investigate clinical and pathological features related to early versus late relapses in a real-world cohort of BC patients.
METHODS: To identify factors related to early (≤ 2 years) and late (≥ 5 years) relapse in women with stage I-III BC, hormone receptor (HR)-positive and human epidermal growth factor receptor 2-negative (HER2-), and HR-negative (HR -)/HER2 - by immunohistochemistry from El Álamo IV registry, logistic regression model was performed. To explore relapse dynamics, multivariate Cox regression models and annual hazard rates of relapses were reported.
RESULTS: Of the 1493 relapses, early, intermediate, and late relapses represented 28.3%, 29.7%, and 42.1% of all relapses, respectively. In 1050 patients, of both early and late relapses, age > 70 years (odds ratio [OR] 5.13; 95% confidence interval [CI] 3.23-8.15), stage III (OR 3.22; 95% CI 1.90-5.46), histological grade 3 (OR, 2.93; 95% CI 1.69-5.10), and HR - /HER2 - subtype (OR 10.26; 95% CI 6.55-16.05) were associated with an increase of early relapse risk. Annual hazard rate of loco-regional relapses (LRR) steadily increased over time in patients with HR + /HER2 - tumors, while those with HR - /HER2 - tumors exhibited a fluctuating pattern. For distant relapses (DR), the hazard rate peaked at 2 years and then rise steadily in HR + /HER2 - tumors whereas remained variable in HR - /HER2 - tumors. In multivariate Cox model, LRR was associated with stage, subtype, and histological grade, while DR was additionally influenced by age.
CONCLUSION: Age at diagnosis, stage, histological grade, and tumor subtype were associated with distinct relapse timing patterns. These findings support further research into relapse dynamics and predictors by analyzing real-world data.