Föreläsningar och seminarier Cancer Core Europe Lecture: Insights into the heterogeneity of ER-positive breast cancer – late risk of metastatic recurrence & endocrine treatment benefit

Speaker: Linda Lindström, Assoc. Professor, Dept. of Oncology Pathology, Karolinska Institutet

Host: Ingemar Ernberg

Zoom ID 66629524056


Abstract
Breast cancer (BC) is a heterogeneous disease with the main fundamental difference being whether the tumour is hormone-sensitive or not, i.e. oestrogen receptor-positive (ER+) or negative (ER-). A unique feature of ER+ BC is the long-term risk of metastatic recurrence decades after initial diagnosis, and half or more of all BC metastases in this patient group will be diagnosed LATE i.e. beyond 5 - 10 years after diagnosis as shown by us and others [Johansson & Lindström et al, JCO 2022; Richman & Dowsett, Nat Rev Clin Oncol 2019; Yu & Lindström et al, JAMA Oncology 2019; Pan et al, NEJM 2017].

The factors underlying late risk of metastatic recurrence remain poorly understood. Current research is mainly focused on early risk, partly due to the lack of tumour samples from patients with complete longterm follow-up. Late risk is clinically important in particular for younger premenopausal patients with a long post cancer life expectancy, but also decades of fear about disease recurrence. Young premenopausal women with BC have a worse prognosis as compared to postmenopausal women, and menopausal status itself has been suggested to be an independent risk factor related to the hormonal milieu. My research focus is on longterm risk of metastatic disease, and how risk and endocrine treatment benefit is influenced by menopausal status and tumour biology including standard tumour markers, intra-tumour heterogeneity, and tumour microenvironment using unique clinical trials with complete longterm follow-up.