The Breast Cancer Index (BCI) and BCI node-positive (BCIN+) risk scores are effective at estimating the individual risk of overall and late distant recurrent (DR) breast cancer, including in HR-positive early breast cancer, according to research from the ASCO 2023 Annual Meeting.  

The researchers calculated the BCI/BCIN+ continuous risk scores for 1,285 patients with non-invasive cancer (group N0) and 1,762 patients with breast cancer spread to 1-3 lymph nodes or in internal mammary lymph nodes (group N1). They evaluated the hazard ratios and confidence intervals for BCI/BCIN+ continuous risk scores after adjusting for factors such as age, size of tumor, grade, and treatment. They estimated the 10-year risk of overall recurrence as well as risk of late DR (between 5 years and 10 years).   

In patients who did not undergo adjuvant chemotherapy and for patients who were DR-free at 5 years, the researchers evaluated overall and late DR continuous risk curves “to reflect the two key time points for breast cancer treatment decision-making.”  

Concerning overall DR, BCI was significantly prognostic for patients in the N0 group (1,197 patients; HR = 1.39; 95% CI, 1.25-1.54; P < .001) as well as in the N1 group for patients who did not undergo chemotherapy (1,319 patients; HR = 4.29; 95% CI, 2.93-6.28; P < .001).   

BCI was also significantly prognostic for late DR among patients in the N0 group (1,285 patients; HR = 1.23; 95% CI, 1.07-1.42; P < .001) and BCIN+ was prognostic in the N1 group (1,762 patients; HR = 2.78; 95% CI, 1.75-4.43; P < .001).  

In a subset of patients with HER2-negative breast cancer, BCI/BCIN+ was prognostic for overall DR in the N0 group (978 patients; HR = 1.52; 95% CI, 1.34-1.73; P < .001) and N1 group (1,132 patients; HR = 4.04; 95% CI, 2.66-6.13; P < .001) as well as late DR in the N0 group (1,063 patients; HR = 1.31; 95% CI, 1.11-1.53; P < .001) and N1 group (1,503 patients; HR = 2.87; 95% CI, 1.17-4.81; P < .001).  

“Results from this largest BCI study to date further support the use of BCI to provide individualized risk estimates for both overall and late DR in women with HR+ breast cancer to aid in personalized decision-making for adjuvant therapy,” wrote John M.S. Bartlett, BSc, PhD, of the Cancer Research UK Scotland Centre at the University of Edinburgh.  

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Reference:  

https://meetings.asco.org/abstracts-presentations/218423  

Disclosures: Some authors declared financial ties to drugmakers. See full study for details. This study was supported by Hologic.  

Photo Credit: Getty Images. 

By Jeff Craven, MD /alert Contributor