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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2017

01-02-2017 | Epidemiology

Prognostic impact of metastatic pattern in stage IV breast cancer at initial diagnosis

Authors: Bernardo Amadeo Leone, Carlos Teodoro Vallejo, Alberto Omar Romero, Mario Raúl Machiavelli, Juan Eduardo Pérez, Julieta Leone, José Pablo Leone

Published in: Breast Cancer Research and Treatment | Issue 3/2017

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Abstract

Purpose

To analyze the prognostic influence of metastatic pattern (MP) compared with other biologic and clinical factors in stage IV breast cancer at initial diagnosis (BCID) and evaluate factors associated with specific sites of metastases (SSM).

Methods

We evaluated women with stage IV BCID with known metastatic sites, reported to the Surveillance, Epidemiology and End Results program from 2010 to 2013. MP was categorized as bone-only, visceral, bone and visceral (BV), and other. Univariate and multivariate analyses determined the effects of each variable on overall survival (OS). Logistic regression examined factors associated with SSM.

Results

We included 9143 patients. Bone represented 37.5% of patients, visceral 21.9%, BV 28.8%, and other 11.9%. Median OS by MP was as follows: bone 38 months, visceral 21 months, BV 19 months, and other 33 months (P < 0.0001). Univariate analysis showed that higher number of metastatic sites had worse prognosis. In multivariate analysis, older age (hazard ratio 1.9), black race (hazard ratio 1.17), grade 3/4 tumors (hazard ratio 1.6), triple-negative (hazard ratio 2.24), BV MP (hazard ratio 2.07), and unmarried patients (hazard ratio 1.25) had significantly shorter OS. As compared with HR+/HER2− tumors, triple-negative and HR−/HER2+ had higher odds of brain, liver, lung, and other metastases. HR+/HER2+ had higher odds of liver metastases. All three subtypes had lower odds of bone metastases.

Conclusions

There were substantial differences in OS according to MP. Tumor subtypes have a clear influence among other factors on SSM. We identified several prognostic factors that could guide therapy selection in treatment naïve patients.
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Metadata
Title
Prognostic impact of metastatic pattern in stage IV breast cancer at initial diagnosis
Authors
Bernardo Amadeo Leone
Carlos Teodoro Vallejo
Alberto Omar Romero
Mario Raúl Machiavelli
Juan Eduardo Pérez
Julieta Leone
José Pablo Leone
Publication date
01-02-2017
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2017
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-016-4066-7

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