{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:57:11Z","timestamp":1791298631055,"version":"4.1.0"},"reference-count":91,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2004,11,1]],"date-time":"2004-11-01T00:00:00Z","timestamp":1099267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Learning Objectives<\/jats:title>\n                    <jats:p>After completing this course, the reader will be able to:<\/jats:p>\n                    <jats:p>Differentiate between prognostic and predictive factors in early-stage breast cancer. Identify prognostic factors used to determine the risk of recurrence and death for a patient with early-stage breast cancer. Identify predictive factors used to determine the optimal therapy for a patient with early-stage breast cancer.<\/jats:p>\n                    <jats:p>Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com<\/jats:p>\n                    <jats:p>Breast cancer is the most common malignancy among American women. Due to increased screening, the majority of patients present with early-stage breast cancer. The Oxford Overview Analysis demonstrates that adjuvant hormonal therapy and polychemotherapy reduce the risk of recurrence and death from breast cancer. Adjuvant systemic therapy, however, has associated risks and it would be useful to be able to optimally select patients most likely to benefit. The purpose of adjuvant systemic therapy is to eradicate distant micrometastatic deposits. It is essential therefore to be able to estimate an individual patient's risk of harboring clinically silent micrometastatic disease using established prognostic factors. It is also beneficial to be able to select the optimal adjuvant therapy for an individual patient based on established predictive factors. It is standard practice to administer systemic therapy to all patients with lymph node-positive disease. However, there are clearly differences among node-positive women that may warrant a more aggressive therapeutic approach. Furthermore, there are many node-negative women who would also benefit from adjuvant systemic therapy. Prognostic factors therefore must be differentiated from predictive factors. A prognostic factor is any measurement available at the time of surgery that correlates with disease-free or overall survival in the absence of systemic adjuvant therapy and, as a result, is able to correlate with the natural history of the disease. In contrast, a predictive factor is any measurement associated with response to a given therapy. Some factors, such as hormone receptors and HER2\/neu overexpression, are both prognostic and predictive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1634\/theoncologist.9-6-606","type":"journal-article","created":{"date-parts":[[2004,11,23]],"date-time":"2004-11-23T14:29:11Z","timestamp":1101220151000},"page":"606-616","source":"Crossref","is-referenced-by-count":469,"title":["Prognostic and Predictive Factors in Early-Stage Breast Cancer"],"prefix":"10.1093","volume":"9","author":[{"given":"Mary","family":"Cianfrocca","sequence":"first","affiliation":[{"name":"Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori J.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,11,1]]},"reference":[{"key":"2021122209453534800_R1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3322\/canjclin.51.1.15","article-title":"Cancer statistics, 2001","volume":"51","author":"Landis","year":"2001","journal-title":"CA Cancer J Clin"},{"key":"2021122209453534800_R2","doi-asserted-by":"crossref","first-page":"138","DOI":"10.3322\/canjclin.49.3.138","article-title":"Global breast cancer mortality statistics","volume":"49","author":"Mettlin","year":"1999","journal-title":"CA Cancer J Clin"},{"key":"2021122209453534800_R3","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1002\/(SICI)1097-0142(19980915)83:6<1262::AID-CNCR28>3.0.CO;2-2","article-title":"The National Cancer Data Base 10-year survey of breast cancer treatment at hospitals in the United States","volume":"83","author":"Bland","year":"1998","journal-title":"Cancer"},{"key":"2021122209453534800_R4","first-page":"1451","article-title":"Early Breast Cancer Trialists' Collaborative Group","volume":"351","author":"Tamoxifen for early breast cancer: an overview of the randomised trials","year":"1998","journal-title":"Lancet"},{"key":"2021122209453534800_R5","first-page":"930","article-title":"Early Breast Cancer Trialists' Collaborative Group","volume":"352","author":"Polychemotherapy for early breast cancer: an overview of the randomised trials","year":"1998","journal-title":"Lancet"},{"key":"2021122209453534800_R6","first-page":"385","article-title":"The evolution of breast cancer surgery: past, present, and future","volume":"5","author":"Fisher","year":"1978","journal-title":"Semin Oncol"},{"key":"2021122209453534800_R7","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/BF00666054","article-title":"Do we really need prognostic factors for breast cancer?","volume":"30","author":"Clark","year":"1994","journal-title":"Breast Cancer Res Treat"},{"key":"2021122209453534800_R8","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1002\/ssu.2980050206","article-title":"Prognostic factors in breast cancer","volume":"5","author":"Saez","year":"1989","journal-title":"Semin Surg Oncol"},{"key":"2021122209453534800_R9","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1002\/1097-0142(19830415)51:8<1333::AID-CNCR2820510802>3.0.CO;2-T","article-title":"Breast cancer in the medial half; results of the 1978 national survey of the American College of Surgeons","volume":"51","author":"Nemoto","year":"1983","journal-title":"Cancer"},{"key":"2021122209453534800_R10","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1002\/1097-0142(19831101)52:9<1551::AID-CNCR2820520902>3.0.CO;2-3","article-title":"Relation of the number of positive axillary nodes to the prognosis of patients with primary breast cancer. 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