Breast cancer severity score is an innovative system for prognosis

Research output: Contribution to journalArticle

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Abstract

Background Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. Methods Medical records of 419 patients with a diagnosis of breast cancer from a university hospital between 1997 and 2002 were reviewed. Tumor characteristics were given a value reflecting the impact on survival. Tumor diameter was assigned 1 point per cm, specifically: 1 point for 0.1 to 1 cm, 2 points for 1.1 to 2 cm, 3 points for 2.1 to 5 cm, and 4 points for 5.1 cm and over. Nodal status was assigned 1 point if the patient had 1 to 3 positive nodes, 5 points if 4 to 10 positive nodes were found, and 10 points if more than 10 nodes were identified. Hormone receptor status was given 1 point if either estrogen or progesterone receptors were not present or 2 points if both were absent. The breast cancer severity score (BCSS) was used to analyze overall and disease-free survival by Kaplan-Meier analysis. Significance of differences in survival was determined by log-rank analysis. Results An increased severity score was inversely proportional to overall and disease-free survivals. A BCSS of greater than 7 was most predictive of outcome with 5-year survival of 68%; and a BCSS of less than 7 had a 5-year survival of 98% (P = 0.0028). A BCSS of greater than 7 also discriminated disease-free survival within stage II (P = 0.02) and stage III (P = 0.01). Conclusions The BCSS provides a better resolution of outcome than traditional staging, and works both for overall survival and within specific stages. Using the BCSS, management and follow-up can be specifically tailored for low- and high-risk patients.

Original languageEnglish (US)
Pages (from-to)404-408
Number of pages5
JournalAmerican Journal of Surgery
Volume186
Issue number4
DOIs
StatePublished - Oct 2003

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Breast Neoplasms
Survival
Disease-Free Survival
Hormones
Neoplasms
Kaplan-Meier Estimate
Progesterone Receptors
Estrogen Receptors
Medical Records

Keywords

  • Biologic characteristics
  • Prognostic tool
  • Scoring system

ASJC Scopus subject areas

  • Surgery

Cite this

Breast cancer severity score is an innovative system for prognosis. / Jimenez-Lee, Ricardo; Ham, Lyle (Bruce); Vetto, John; Pommier, Rodney.

In: American Journal of Surgery, Vol. 186, No. 4, 10.2003, p. 404-408.

Research output: Contribution to journalArticle

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title = "Breast cancer severity score is an innovative system for prognosis",
abstract = "Background Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. Methods Medical records of 419 patients with a diagnosis of breast cancer from a university hospital between 1997 and 2002 were reviewed. Tumor characteristics were given a value reflecting the impact on survival. Tumor diameter was assigned 1 point per cm, specifically: 1 point for 0.1 to 1 cm, 2 points for 1.1 to 2 cm, 3 points for 2.1 to 5 cm, and 4 points for 5.1 cm and over. Nodal status was assigned 1 point if the patient had 1 to 3 positive nodes, 5 points if 4 to 10 positive nodes were found, and 10 points if more than 10 nodes were identified. Hormone receptor status was given 1 point if either estrogen or progesterone receptors were not present or 2 points if both were absent. The breast cancer severity score (BCSS) was used to analyze overall and disease-free survival by Kaplan-Meier analysis. Significance of differences in survival was determined by log-rank analysis. Results An increased severity score was inversely proportional to overall and disease-free survivals. A BCSS of greater than 7 was most predictive of outcome with 5-year survival of 68{\%}; and a BCSS of less than 7 had a 5-year survival of 98{\%} (P = 0.0028). A BCSS of greater than 7 also discriminated disease-free survival within stage II (P = 0.02) and stage III (P = 0.01). Conclusions The BCSS provides a better resolution of outcome than traditional staging, and works both for overall survival and within specific stages. Using the BCSS, management and follow-up can be specifically tailored for low- and high-risk patients.",
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AU - Jimenez-Lee, Ricardo

AU - Ham, Lyle (Bruce)

AU - Vetto, John

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N2 - Background Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. Methods Medical records of 419 patients with a diagnosis of breast cancer from a university hospital between 1997 and 2002 were reviewed. Tumor characteristics were given a value reflecting the impact on survival. Tumor diameter was assigned 1 point per cm, specifically: 1 point for 0.1 to 1 cm, 2 points for 1.1 to 2 cm, 3 points for 2.1 to 5 cm, and 4 points for 5.1 cm and over. Nodal status was assigned 1 point if the patient had 1 to 3 positive nodes, 5 points if 4 to 10 positive nodes were found, and 10 points if more than 10 nodes were identified. Hormone receptor status was given 1 point if either estrogen or progesterone receptors were not present or 2 points if both were absent. The breast cancer severity score (BCSS) was used to analyze overall and disease-free survival by Kaplan-Meier analysis. Significance of differences in survival was determined by log-rank analysis. Results An increased severity score was inversely proportional to overall and disease-free survivals. A BCSS of greater than 7 was most predictive of outcome with 5-year survival of 68%; and a BCSS of less than 7 had a 5-year survival of 98% (P = 0.0028). A BCSS of greater than 7 also discriminated disease-free survival within stage II (P = 0.02) and stage III (P = 0.01). Conclusions The BCSS provides a better resolution of outcome than traditional staging, and works both for overall survival and within specific stages. Using the BCSS, management and follow-up can be specifically tailored for low- and high-risk patients.

AB - Background Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. Methods Medical records of 419 patients with a diagnosis of breast cancer from a university hospital between 1997 and 2002 were reviewed. Tumor characteristics were given a value reflecting the impact on survival. Tumor diameter was assigned 1 point per cm, specifically: 1 point for 0.1 to 1 cm, 2 points for 1.1 to 2 cm, 3 points for 2.1 to 5 cm, and 4 points for 5.1 cm and over. Nodal status was assigned 1 point if the patient had 1 to 3 positive nodes, 5 points if 4 to 10 positive nodes were found, and 10 points if more than 10 nodes were identified. Hormone receptor status was given 1 point if either estrogen or progesterone receptors were not present or 2 points if both were absent. The breast cancer severity score (BCSS) was used to analyze overall and disease-free survival by Kaplan-Meier analysis. Significance of differences in survival was determined by log-rank analysis. Results An increased severity score was inversely proportional to overall and disease-free survivals. A BCSS of greater than 7 was most predictive of outcome with 5-year survival of 68%; and a BCSS of less than 7 had a 5-year survival of 98% (P = 0.0028). A BCSS of greater than 7 also discriminated disease-free survival within stage II (P = 0.02) and stage III (P = 0.01). Conclusions The BCSS provides a better resolution of outcome than traditional staging, and works both for overall survival and within specific stages. Using the BCSS, management and follow-up can be specifically tailored for low- and high-risk patients.

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