Predictors of recurrence during years 5-14 in 46,138 women with ER+ breast cancer allocated 5 years only of endocrine therapy (ET).
Bibliographic record
Abstract
505 Background: For operable ER+ breast cancer, 5 years of ET with tamoxifen and/or aromatase inhibitors reduces breast cancer mortality in years 0-4 and years 5-14 by about a third. Extending ET past year 5 further reduces risks in years 5-14, but has further side-effects. Knowledge of the effects of prognostic factors on absolute risks of distant recurrence and death in years 5-14 if ET stops at year 5 could help decide whether to extend ET after year 5 for lower-risk patients. Methods: Data on 46,138 individual patients with ER+ disease (diameter T1 or T2 only, pathological nodal status N0, N1-3 or N4-9 only) in trial groups allocated 5 years only of ET yielded the effects on outcomes in years 5-14 of tumor diameter, nodal status and, if available, grade, Ki-67, PR and HER-2 status. Cox regression analyses of each factor were adjusted for age, trial group, and the other factors. Results: In ER+ disease, recurrence rates continued steadily throughout the first 20 years. Distant recurrence rates in years 5-14 still depended on initial N-stage (N1-3 vs N0: RR = 2.08, 95%CI 1.87 – 2.32), T-stage (T2N0 vs T1N0: RR = 1.73, 1.53 – 1.95), grade (T1N0, high vs low: RR = 2.02, 1.44 – 2.83) and Ki67 ( ≥ 20% vs 0-13%: RR = 1.63, 1.23 – 2.16). Similar associations were seen for breast cancer mortality, but contralateral cancer rates (0.3%/year) were little related to these risk factors. For T1N0 disease of low, moderate, and high grade, the risks in years 5-14 were, respectively, 5%, 8%, and 10% for distant recurrence (Table) and 12%, 15% and 17% for any recurrence. Conclusions: Even after 5 years of ET, ER+ recurrence risk continued steadily over years 5-14. Although this risk was less for patients with favorable TN status and grade, even those with low-grade T1N0 disease had an appreciable risk of distant recurrence. Distant recurrence in years 5-14 in ER+ disease allocated 5 years only of endocrine therapy. No. of women Annual, Years 5-9 Rate (%), Years 10-14 Cumulative risk (%), years 5-14 Trend P Nodes: N0 23,870 1.0 1.1 9.8 1-3 16,630 2.0 1.5 15.6 4-9 5,638 4.1 2.6 27.7 < 0.0001 Diameter, N0 only: T1 16,286 0.7 0.9 7.9 T2 7,584 1.6 1.3 13.6 < 0.0001 Grade, T1N0 only: Low 2,996 0.4 0.7 5.4 Moderate 6,120 0.8 0.9 8.1 High 2,135 1.0 1.2 10.0 < 0.0001
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".