Identification of patients with early HR+ HER2- breast cancer at high risk of recurrence

Peter Fasching*, Hans Kreipe, Lucia Del Mastro, Eva Ciruelos, Gilles Freyer, Agnieszka Korfel, Nadia Chouaki, Clemens Stoffregen, Francisco Sapunar, David Cameron

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Breast cancer incidence has increased in the last two decades and, simultaneously, survival has improved due to earlier detection and
improved treatment options. Despite this improvement, locoregional recurrences and distant metastases occur in up to 10 and 30% of women diagnosed with early breast cancer, respectively. Around 70% of breast
cancers are hormone receptor positive (HR+), human epidermal growth factor receptor 2 negative (HER2-), and associated with a persistent risk of relapse up to 20 years after diagnosis/initial treatment. We conducted
a narrative review by combining PubMed searches with our clinical experience to describe patient characteristics, biomarkers, and genomic profiling tools available to clinicians for the identification of patients with
HR+, HER2- early breast cancer at high risk of recurrence and to provide recommendations to classify patients into recurrence risk categories. National and international treatment guidelines are also summarised.
Accurate assessment of the risk of recurrence in these patients is crucial as the predicted risk guides treatment decisions; imprecise estimations can result in over- or undertreatment, with either scenario having negative consequences for patients. Multiple prognostic tools and factors are recommended for early breast cancer, and no single test provides accurate prognosis in isolation. Since no single test can provide accurate prognosis in isolation, a combination of tools should be used. Risk thresholds are important to guide optimised and balanced therapeutic decisions in HR+, HER2- early breast cancer. However, prognostic assessment should be performed on a case-by-case basis, making
patient-specific prognostic approaches essential to avoid over- or undertreatment.
Original languageEnglish
Pages (from-to)164-184
JournalGeburtshilfe und Frauenheilkunde
Volume84
DOIs
Publication statusPublished - 8 Feb 2024

Keywords / Materials (for Non-textual outputs)

  • Early breast cancer
  • HR+
  • HER2-
  • Risk of recurrence
  • prediction of risk

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