Survival with metastatic breast cancer based on initial presentation, de novo versus relapsed
- 20 December 2016
- journal article
- research article
- Published by Springer Science and Business Media LLC in Breast Cancer Research and Treatment
- Vol. 161 (3), 549-556
- https://doi.org/10.1007/s10549-016-4080-9
Abstract
We hypothesized different Overall Survival (OS) in metastatic breast cancer (MBC) after relapse vs de novo presentation. We identified women in British Columbia with MBC diagnosed between 01/2001 and 12/2009. OS from MBC was calculated for relapsed vs de novo cohorts in 3 subgroups, based on hormone receptors (HR) and HER2 status. Age at MBC, disease-free interval (DFI), de novo vs relapsed, year of MBC diagnosis, and systemic treatment were entered into univariable and multivariable analyses. We identified 3645 pts with known HR of which 2796 had known HER2. Median follow-up was 91 months. Median OS was longer for de novo vs relapsed MBC: HR+/HER2- 34 versus 23 months (mos) (p < 0.0001), HR−/HER2- (TN) 11 versus 8 mos (p = 0.02), HER2+ 29 versus 15 mos (p < 0.0001). For TN disease, no variable independently discriminated a group with increased risk of death. For both the HR +/HER2- and the HER2 + groups, relapsed vs de novo status (HzR 1.4 [95% CI 1.2–1.5; p < 0.0001], and HzR 1.6 [95% CI 1.4–1.9; p < 0.0001], respectively) and age >50 (HzR 1.2 [95% CI 1.1–1.4; p = 0.001] and HzR 1.3 [95% CI 1.1–1.5; p = 0.01], respectively) were associated with increased risk of death on multivariable analysis. These data provide information that may guide discussions about prognosis between physicians and patients with MBC. In addition, it highlights the importance of stratifying for initial stage at diagnosis in future MBC therapeutic trials.Keywords
This publication has 29 references indexed in Scilit:
- Treatment patterns and clinical outcomes for patients with de novo versus recurrent HER2-positive metastatic breast cancerBreast Cancer Research and Treatment, 2014
- Tumour heterogeneity in the clinicNature, 2013
- Patterns of Recurrence and Outcome According to Breast Cancer Subtypes in Lymph Node–Negative Disease: Results From International Breast Cancer Study Group Trials VIII and IXJournal of Clinical Oncology, 2013
- Comprehensive molecular portraits of human breast tumoursNature, 2012
- Heterogeneity in breast cancerJCI Insight, 2011
- Metastatic Behavior of Breast Cancer SubtypesJournal of Clinical Oncology, 2010
- Survival differences among women with de novo stage IV and relapsed breast cancerAnnals Of Oncology, 2010
- Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trialsThe Lancet, 2005
- Breast carcinoma survival in Europe and the United StatesCancer, 2003
- THE ROLE OF CHEMOTHERAPY FOR METASTATIC BREAST CANCERHematology/Oncology Clinics of North America, 1999