Factors Associated with Time to Progression and Overall Survival in Patients with De Novo Metastatic Breast Cancer: A Colombian Cohort

Abstract

Purpose About 10% of breast cancer (BC) is diagnosed in stage IV. This study sought to identify factors associated with time to progression (TTP) and overall survival (OS) in a cohort of patients diagnosed with de novo metastatic breast cancer (MBC), from a single cancer center in Colombia, given that information on this aspect is limited. Methodology An observational, analytical, and retrospective cohort study was carried out. Time to progression and OS rates were estimated using the Kaplan–Meier survival functions. Cox models were developed to assess association between time to progression and time to death, using a group of fixed variables. Results Overall, 175 patients were included in the study; 33.7% of patients had luminal B HER2-negative tumors, 49.7% had bone involvement, and 83.4% had multiple metastatic sites. Tumor biology and primary tumor surgery were the variables associated with TTP and OS. Patients with luminal A tumors had the lowest progression and mortality rates (10 per 100 patients/year (95% CI: 5.0-20.0) and 12.6 per 100 patients/year (95% CI: 6.9-22.7), respectively), and patients with triple-negative tumors had the highest progression and mortality rates (40 per 100 patients/year (95% CI: 23.2-68.8) and 44.1 per 100 patients/year (95% CI: 28.1-69.1), respectively). Across the cohort, the median TTP was 2.1 years (95% CI: 1.6; the upper limit cannot be reached) and the median OS was 2.4 years (95% CI: 2-4.3). Conclusions In this cohort, patients with luminal A tumors and those who underwent tumor surgery given that they presented clinical benefit (CB) after initial systemic treatment, had the lowest progression and mortality rates. Overall, OS was inferior to other series due to high tumor burden and difficulties in accessing and continuing oncological treatments.

Abscopal Effect Following Cryoablation in a Patient with Metastatic Breast Cancer

“…As a recent example, PARP inhibitors such as olaparib and talazoparib, have been approved for the subset of BRCA carriers with metastatic HER2-negative breast cancer [2]. Approximately 5-10% of breast cancer patients are diagnosed with metastatic breast cancer, and unfortunately have grimmer prognoses compared to those diagnosed with earlier stages of breast cancer [3]. The survival rate of metastatic breast cancer patients is 20% over a 5-year period, and these patients also have less treatment options compared to patients with early disease [4].…”

Supervivencia en pacientes con cáncer de mama estadio IV inicial con manejo sistémico y quirúrgico

“…Con una mediana de edad de 56 años y un predominio de pacientes menopaúsicas, este estudio concuerda con lo reportado en la literatura. A nivel nacional, Díaz et al [14] informaron una mediana de edad de 58,8 años y un 62,9 % de posmenopáusicas. Por su parte, estudios internacionales, en general, reportan una mediana de edad > 50 años [1,[6][7][8][9][15][16][17][18] y una mayoría de pacientes menopaúsicas [5,7,12,17].…”

“…El principal tipo de carcinoma en la cohorte de este estudio fue el ductal infiltrante, de moderado y alto grado, hormonal positivo, lo que es consistente con la literatura mundial [6][7][8][9]11,14,[17][18][19]. Sin embargo, el subgrupo triple negativo, que es de menor presentación en los diversos estudios [6,7,12], ocupó el segundo lugar.…”

Estudios de extensión para la estadificación del cáncer de mama infiltrante. Revisión de la evidencia y abordaje terapéutico en el Instituto Nacional de Cancerología - Colombia

“…Cuando se analiza la enfermedad metastásica de la Unidad Funcional de Seno y Tejidos Blandos del INC, se encuentra que el 90,8% de las pacientes presentan tumores T4, y el 97,7% compromiso ganglionar (N1-3). Por subtipo biológico, los tumores luminales presentan mayor riesgo de metástasis óseas (71,4% en los tumores luminal B y 66,6% en los tumores luminal A), los tumores triples negativo a pulmón y sistema nervioso central (SNC); y los tumores HER2 a SNC, hígado y pulmón (5).…”

“…Teniendo en cuenta este compromiso a distancia, los métodos de estadificación comúnmente utilizados son gammagrafía ósea (GO), radiografía de tórax (RxT) y ecografía hepática (UH). En caso de hallazgos poco claros, se realizan estudios adicionales como tomografía computarizada (TC) o resonancia magnética (RMN) (5). En pacientes con tumores pequeños y sin compromiso ganglionar, dada la baja probabilidad de enfermedad a distancia, no se ha documentado beneficio en la realización de estas pruebas; de hecho, además del recurso innecesario, los resultados de falsos positivos que requieren de confirmaciones adicionales retrasan los tratamientos, generan ansiedad en las pacientes y aumentan los costos (6).…”