Description

Gonzalez-Angulo et al identified factors predictive of distant metastases in a woman with breast cancer who has had a complete pathologic response to neoadjuvant chemotherapy. This can help identify a patient who may benefit from closer monitoring and more aggressive management. The authors are from the University of Texas M.D. Anderson Cancer Center in Houston.


 

Patient selection: Woman with breast cancer who has had a complete response following neoadjuvant chemotherapy.

 

Patient exclusion: Stage IV

 

Parameters:

(1) clinical extent (clinical stage and/or inflammatory carcinoma)

(2) number of lymph nodes sampled

(3) menopausal status

Parameter

Finding

Points

clinical extent

inflammatory breast cancer, any stage

1

 

Stage I, II or IIIA and non-inflammatory

0

 

Stages IIIB or IIIC and non-inflammatory

1

number of lymph nodes sampled

<= 10

1

 

> 10

0

menopausal status

pre-menopausal

1

 

peri- or post-menopausal

0

 

total number of risk factors =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 3

• The risk of distant metastases increases as the number of risk factors increases.

 

Number of Risk Factors

Risk of Distant Metastases at 10 Years

0

3%

1

12%

2

23%

3

69%

 


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