Overall Survival of Patients With Locoregional and Metastatic Breast Cancer: Is the Influence of Baseline Characteristics the Same?

Abstract

Aim: To compare the overall survival (OS) of patients with locoregional and metastatic breast cancer (BC) considering baseline demographic, clinical and contextual characteristics. Materials and Methods: A retrospective analysis of a cancer registry was conducted, using the Kaplan-Meier and Mantel-Cox analyses for the calculation of median OS and cumulative survival. Results: The median OS was 112 months, being longer in patients with locoregional versus those with metastatic BC at diagnosis (115 vs. 31 months, p<0.001). The cumulative survival at 1, 3 and 5 years were 94.9%, 85.6% and 76.5%, respectively. More recent year of diagnosis [hazard ratio (HR)=1.09] and age at diagnosis (≥65 vs. 40 years, HR=2.79) and presence of metastatic disease (HR=5.69) were associated with a shorter OS. The region of residence, morphology and topography of the tumor were also associated with survival in patients with BC. Rurality was only associated with lower survival in patients with metastatic BC. Conclusion: This study identified significant differences in the median OS of patients with locoregional and those with metastatic BC considering their baseline characteristics.Breast cancer (BC) is the most frequent malignant disease in women worldwide (1, 2), in Europe (2, 3) and in Portuguese women (3-9). Survival of patients with BC has expanded over time (10-16), an improvement that can be attributed to the increase in cases being diagnosed early (11,(17)(18)(19)(20), screening actions (11-13, 17, 20), and treatment advances (10-12, 17, 20-22). The survival of patients with BC has also been associated with other factors such as stage (10-14, 17, 20-23) and age at diagnosis (4, 5, 6-12, 14, 15, 16, 21, 24-26), rurality (25, 27), and other prognostic factors (16, 28) such as the histology of the tumor (13,16,28,29) and tumor location (30).To date, few publications have compared the overall survival of patients with locoregional and metastatic BC and correlated it with the patients' baseline characteristics. A study conducted in patients diagnosed with BC in 1990-1999 in 10 European countries identified 5-and 10-year all-cause overall survival rates of 89% and 80%, respectively ( 13). An analysis conducted in the Cote D'Or registry on patients with metastatic BC diagnosed in 2000-2011 showed survival rates at 1 and 2 years of 67.3% and 47.5%, respectively, with a median survival of 22.7 months ( 16). Another publication on this topic reported overall survival of 92.9%, 77.6% and 65.5% at 1, 3 and 5 years, respectively, in Italian women diagnosed in 1979-1981 (24). A further study conducted on Scottish women with non-metastatic BC diagnosed in 1987-1993 showed that the 8-year overall survival decreased with age (12), and another analysis of Turkish women conducted between 1995 and 2008 found a median survival of 120 months, with 90% survival at the 5-year cut-off date ( 22). Additionally, a retrospective study conducted on patients with metastatic BC diagnosed in 1980-2009 in Germany reported a median survival of 85 months, with w...

Prognostic Value of Dual-Time-Point 18F-Fluorodeoxyglucose PET/CT in Metastatic Breast Cancer: An Exploratory Study of Quantitative Measures

“…Breast cancer is the most commonly diagnosed cancer in women and one of the most frequent causes of cancer death worldwide [1]. Overall 10-year survival for patients diagnosed with metastasis is around 10% [2].…”

Racial disparities in overall survival after the introduction of cyclin-dependent kinase 4/6 inhibitors for patients with hormone receptor-positive, HER2-negative metastatic breast cancer

“…In addition, NHB and Hispanic women have a higher incidence of de novo metastatic disease than NHW women [12][13][14]. Multiple factors have been proposed as etiology for racial disparities, such as biological [15][16][17] and socioeconomic factors [18][19][20]. Relative to NHW, HR+/HER2-tumors from NHB women are characterized by more aggressive molecular features such as higher contributions from homologous recombination de ciency, TP53 mutations, and increased structural variation; furthermore, GATA3 mutations are more frequent in NHB regardless of breast cancer subtype [16,21].…”