Prognosis of metastatic breast cancer: are there differences between patients with de novo and recurrent metastatic breast cancer?

Lobbezoo, D.J.A.; Kampen, Roel J.W. van; Voogd, Adri C.; Dercksen, M. W.; Berkmortel, Franchette van den; Smilde, Tineke J.; Wouw, Agnès J. van de; Peters, F. P. J.; Riel, J.M.G.H. van; Peters, Natascha A. J. B.; Boer, Maaike de; Peer, P.G.M.; Tjan‐Heijnen, Vivianne C. G.

doi:10.1038/bjc.2015.127

Cited by 203 publications

(203 citation statements)

References 25 publications

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“…However, although the difference in the prognostic outcomes of metastatic diseases between de novo and recurrent BC patients is still unclear, these patients have often been treated using the same strategy. Previous reports have indicated that de novo BC patients have better survival than recurrent BC patients (10)(11)(12), and our study also confirms these results. Metastatic BC forms heterogeneous groups with varying prognostic outcomes, requiring the development of a distinct treatment approach for each BC subtype (14)(15)(16).…”

Section: Discussionsupporting

confidence: 91%

“…BC patients who experienced a distant recurrence within or soon after adjuvant treatment may present with therapeutic resistance, also leading to poorer prognostic outcomes. In contrast, de novo disease is therapy-naive, and therefore likely to show less resistance to systemic therapy (10)(11)(12). BC patients with longer DFI or patients who developed a distant recurrence some years after adjuvant treatment may have a better response to systemic therapy.…”

Section: Discussionmentioning

confidence: 99%

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The Difference in Prognostic Outcomes Between De Novo Stage IV and Recurrent Metastatic Patients with Hormone Receptor-positive, HER2-negative Breast Cancer

Yamamura

Kamigaki

Fujita

et al. 2018

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Abstract. Background Breast cancer (BC) is the most common malignancy diagnosed in women, and leads to cancer mortality worldwide (1, 2). The majority of BC patients are diagnosed at an early disease stage, receive surgery and adjuvant treatment, and become long-term survivors who can be classified as disease-free (3-5). However, patients that develop metastatic disease during or after standard of care are generally incurable. In these cases a primary treatment goal is symptom palliation (6, 7). Patients with distant metastasis at initial diagnosis are classified as de novo stage IV metastatic patients and can be viewed as a distinct subgroup (8, 9), and these patients could be considered a poor prognostic group with incurable disease. However, a previous report suggested that de novo BC patients tend to have a better prognosis relative to recurrent BC patients (10). De novo BC patients may have a better response to systemic therapy due to their treatment-naïve status, while recurrent BC patients are more likely to show therapeutic resistance to systemic therapy after undergoing adjuvant treatment. There could also be biological differences other than the therapeutic factors between de novo and recurrent BC patients (11-13). Metastatic BC patients could form heterogeneous groups and present with varying metastatic patterns and prognostic outcomes, therefore requiring distinct treatment approaches based on BC subtype (14, 15). Treatment strategies have continuously advanced thanks to improved understanding of the heterogeneity of metastatic disease, which can have distant patterns of recurrence and varying prognostic impacts (15, 16). These approaches, which include endocrine therapies, targeted therapies, and various types of chemotherapies, are selected according to metastatic and prognostic patterns or BC subtypes based on immunohistochemical or molecular classifications (17). Although the difference in metastatic patterns and survival outcomes between de novo and recurrent BC patients is still unclear, these patients have often been treated with the same strategies. The objective of this retrospective study is to examine the prognostic outcomes between these groups of patients, both with the hormone receptor positive (HR+), and HER2-negative (HER2-) subtype. A better understanding of the metastatic course and prognostic factors for these patients 353

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

The Difference in Prognostic Outcomes Between De Novo Stage IV and Recurrent Metastatic Patients with Hormone Receptor-positive, HER2-negative Breast Cancer

Yamamura

Kamigaki

Fujita

et al. 2018

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“…11 As a result, some cases that might have been assigned as stage IIIc in countries that adhered to criteria in the sixth 10 Overall, the proportion of patients in this study with known HR status who had a primary diagnosis of HR-positive LA/MBC was lower (7.8%) than in previously published estimates (approximately 13%-17%). [6][7][8] However, the generalizability of the previous findings is limited, because they were derived from a small number of patient records. In addition, the range of years and geographic regions included in these studies differed from the present study, and comparisons should therefore be interpreted with caution.…”

Section: Esther Bastiaannet Et Almentioning

confidence: 99%

“…Studies of small retrospective databases have reported that of all patients with known HR status, approximately 13% to 17% had a primary diagnosis of HR-positive advanced disease (LA/MBC). [6][7][8] However, these studies did not assess subsequent therapy in this patient group, and, to our knowledge, a comprehensive evaluation of the size of this patient population has not been performed.…”

Section: Introductionmentioning

confidence: 99%

A European, Observational Study of Endocrine Therapy Administration in Patients With an Initial Diagnosis of Hormone Receptor-Positive Advanced Breast Cancer

Bastiaannet

Charman

Johannesen

et al. 2018

Clinical Breast Cancer

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In this observational study we estimated the proportion of postmenopausal breast cancer patients initially diagnosed with hormone receptor (HR)-positive locally advanced or metastatic breast cancer (LA/MBC), using data from 6 European cancer registries (n [ 244,268 with known HR status and disease stage). Approximately 19,002 patients (7.8%) received an initial diagnosis of HR-positive LA/MBC; 74.5% (n [ 14,157) of these received subsequent endocrine therapy as per guideline recommendations. Background: Despite guideline recommendations, reports suggest that a proportion of patients with hormone receptor (HR)-positive locally advanced or metastatic breast cancer (LA/MBC) might not receive endocrine therapy. The aims of this study were to estimate the proportion of postmenopausal patients with an initial (primary) diagnosis of HR-positive LA/MBC in Europe, and to assess the administration of endocrine treatment in these patients. Materials and Methods: Fourteen national and regional cancer registries across Europe were invited to participate in this observational study. Six registries each provided anonymized clinical information on > 5000 postmenopausal women with breast cancer diagnosed between January 2000 and December 2014, including age at diagnosis, estrogen and/or progesterone receptor status, disease stage, and receipt of endocrine therapy. The proportion of patients with an initial diagnosis of HR-positive LA/MBC and, of these, the proportion who received endocrine therapy, was calculated. Results: Registries from Belgium, England, Ireland, Norway, The Netherlands, and Munich, Germany provided data. In total, 316,680 postmenopausal women were diagnosed with breast cancer, including 244,268 with known HR status and disease stage. Of these patients, 19,002 (7.8%) had a primary diagnosis of HR-positive LA/MBC. This proportion ranged from 5.4% (N ¼ 4484) in England to 12.7% (N ¼ 4085) in Germany. Most of these patients (n ¼ 14,157; 74.5%) received endocrine treatment, ranging from 55.5% (n ¼ 445) in Clinical Breast Cancer Month 2017 -1 Norway to 88.1% (n ¼ 443) in Belgium. Conclusion: These results indicate that a sizeable proportion of postmenopausal patients in Europe received a primary diagnosis of HR-positive LA/MBC, and that almost threequarters received subsequent endocrine therapy as per guideline recommendations.

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“…19 O sítio de metástase é um fator prognóstico independente para a sobrevida das mulheres com neoplasia maligna da mama. [16][17][18][19][20][21][22] No Brasil, embora alguns autores tenham avaliado a sobrevida do cân-cer de mama segundo a presença de metástase à distância, 23,24 ainda pouco se abordou essa questão no que se refere aos sítios metastáticos acometidos. Vale lembrar que, além de investigarem o impacto de características inerentes ao tumor, os dados de sobrevida são o parâmetro mais utilizado para avaliar resultados na área oncológica, permitindo identificar avanços diagnósticos e terapêuti-cos, bem como analisar a eficiência global do controle do câncer pelo sistema de saúde.…”

Section: Introductionunclassified

Metastatic breast cancer: clinicopathological features and survival according to the site of metastasis

Brum¹,

Guerra²,

Cintra³

et al. 2017

Medicina (Ribeirão Preto)

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verificou-se metástase óssea isolada em 26,6% das pacientes e metástase extraóssea isolada em 45,2%, sendo que o restante exibiu metástases em ambos os sítios. Entre as pacientes com metástase óssea isolada, 68,2% utilizaram hormonioterapia, em relação a 44,9% daquelas com metástase extraóssea (p=0,06); tumores com receptor de progesterona positivo foram observados em 63,6% e 43,3% das pacientes em cada grupo (óssea isolada versus extraóssea), respectivamente (p=0,09). A sobrevida global em cinco anos foi 38,5% (IC95%: 18,6-58,2) para as pacientes com metástase óssea isolada e 24,8% (IC95%: 15,2-35,7) para aquelas com metástase extraóssea. Já o tempo médio de sobrevida após o diagnóstico de metástase foi de 19,6 meses nos casos de metástase óssea isolada e 12,1 meses naqueles com envolvimento extraósseo. Conclusões: a presença de positividade hormonal e o uso de hormonioterapia parecem estar associados a maior ocorrência de metástase óssea isolada, que, por sua vez, sinaliza para maior tempo de sobrevida em relação à metástase extraóssea.Palavras-chave: Neoplasias da Mama. Metástase Neoplásica; Análise de Sobrevida. Prognóstico.

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Prognosis of metastatic breast cancer: are there differences between patients with de novo and recurrent metastatic breast cancer?

Cited by 203 publications

References 25 publications

The Difference in Prognostic Outcomes Between De Novo Stage IV and Recurrent Metastatic Patients with Hormone Receptor-positive, HER2-negative Breast Cancer

The Difference in Prognostic Outcomes Between De Novo Stage IV and Recurrent Metastatic Patients with Hormone Receptor-positive, HER2-negative Breast Cancer

A European, Observational Study of Endocrine Therapy Administration in Patients With an Initial Diagnosis of Hormone Receptor-Positive Advanced Breast Cancer

Metastatic breast cancer: clinicopathological features and survival according to the site of metastasis

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