Table 1.

The 10-y cumulative risk estimates of local and distant recurrence and contralateral breast cancer among women with early-stage breast cancer at 6 mo after definitive breast surgery by cancer stage (references shown in parentheses)

No. of our patientsLocal recurrenceContralateral breast cancerLocal recurrence + contralateral breast cancerDistant recurrence
Patients with DCIS
    BCS alone433% (15)5% (15)3% (15)
    BCS + radiation therapy4016% (15)7% (15)2% (15)
    BCS + tamoxifen732% (14)1%*
    BCS + radiation therapy + tamoxifen4914% (13, 14)1% (13)
    Mastectomy691% (17)5% (16)1% (17)
Patients with EIBC and negative nodes
    BCS alone444% (1)6% (19)14%
    BCS + radiation therapy3215% (1)6% (19)7%
    BCS + systemic adjuvant therapy1725%6% (19)7%
    BCS + radiation therapy + systemic adjuvant therapy1598%§6% (19)5%
    Mastectomy alone928% (1)6% (19)7%
    Mastectomy + radiation therapy73% (1)6% (19)7%
Patients with EIBC and positive nodes
    BCS alone061%6% (19)−**
    BCS + radiation therapy018%††6% (19)−**
    BCS + systemic adjuvant therapy234%6% (19)30%
    BCS + radiation therapy + systemic adjuvant therapy128%§6% (19)13%
    Mastectomy alone1328% (1)6% (19)13%
    Mastectomy + radiation therapy38% (1)6% (19)11%

NOTE: The 10-y cumulative risk estimates were calculated as 1 − (1 − annual risk estimates)10, in which the annual risk estimates were derived from the literature cited or from the calculations specified in the following footnotes.

  • *The risk of distant recurrence was estimated based on the annual risk estimate of distant recurrence in DCIS patients who received BCS alone and proportional risk reductions after radiation therapy (18%) and after radiation therapy plus tamoxifen use (79%).

  • The risk was estimated based on the annual risk of one's breast cancer–specific mortality that was calculated using Adjuvant! Online and was adjusted by a weighting factor (1.6 for estrogen receptor (ER)-positive cases, 1.1 for ER-negative cases, and 1.4 for unknown ER status; ref. 18). For analysis, comorbidity scores of 0, 1, 2, 3, 4, and ≥5 corresponded to the categories used in Adjuvant! Online, namely perfect health, minor problems, average for age, major problems (+10), major problems (+20), and major problems (+30), respectively.

  • The mean value of individualized risk estimates that were calculated using the following equation: annual risk after BCS plus systemic adjuvant therapy = annual risk after BCS alone × (1 − proportional risk reduction due to systemic adjuvant therapy). The proportional risk reduction due to each type of chemotherapy and adjuvant hormone therapy was obtained from the Adjuvant! Online program.

  • §The mean value of individualized risk estimates that were calculated using the following equation: annual risk after BCS plus radiation therapy and systemic adjuvant therapy = annual risk after BCS plus radiation therapy × (1 − proportional risk reduction due to systemic adjuvant therapy).

  • The risk estimates were 1% for patients with bilateral mastectomy (Herrinton et al., 2005).

  • The risk of 17% that was obtained from the literature (Clarke et al., 2005) was added to the risk estimates due to positive nodes (44% + 17% = 61%).

  • **No risk estimate was presented because no patient was in that group (n = 0).

  • ††The risk of 3% that was obtained from the literature (Clarke et al., 2005) was added to the risk estimates due to positive nodes (15%+3% = 18%).