Prognostic value of chronic hepatitis B virus infection in patients with breast cancer in a hepatitis B virus endemic area

Abstract

Background: Except for hepatocellular carcinoma, chronic hepatitis B virus (HBV) infection has also been reported to be associated with increased morbidity and mortality of other cancers. However, the impact of chronic HBV infection on the prognosis of breast cancer (BC) remains unclear. Our study aimed to evaluate the prognostic value of HBV infection for BC in an endemic area of HBV in China.Methods: There was a total of 1,904 patients with early BC who underwent mastectomy or breastconserving surgery enrolled in our study. HBV infection on overall survival (OS) and hepatic metastasis-free survival (HMFS) was the main research indicator for this study.Results: A total of 212 patients (11.1%) were identified with chronic HBV infection due to serum hepatitis B surface antigen (HBsAg) positive. HBsAg-positive patients had inferior OS (84.9% vs. 90.4%, P=0.005) and HMFS (92.5% vs. 97.1%, P=0.016) at 5 years than HBsAg-negative patients. Chronic HBV infection was an independent predictor of poor OS in patients with BC [multivariate analysis; hazard ratio (HR), 1.52; P=0.038], but not for HMFS. Subgroup analysis showed that chronic HBV infection was an unfavorable independent prognostic factor for OS in patients with stage II/III BC (HR, 1.59; P=0.025). The 5-year OS and HMFS rates of HBsAg-positive patients were 81.9% and 90.5% for patients with stage II/III BC, while those rates of HBsAg-negative patients were 88.5% and 96.3%, respectively. In stage I patients, there was no significant difference in 5-year OS (95.8% vs. 97.1%; P=0.629) and HMFS (100.0% vs. 99.0%; P=0.447). Conclusions:In conclusion, chronic HBV infection predicts a worse prognosis in patients with stage II/III BC, but not stage I BC.

HBV Infection Status Does Not Influence the Initial Metastatic Pattern and the Prognosis of Breast Cancer Patients with de novo and Relapsed Metastatic Disease

“… 38 , 40 China has the world’s highest rate of HBV infection, with an estimated 70 million HBsAg carriers and a prevalence of 5% to 6% in the general population. 41 , 42 The prevalence of HBsAg in patients with MBC was 8.5% in the current study, which was consistent with earlier studies that found 8–15% in breast cancer patients 16 , 43 , 44 and basically consistent with the general population in western China. 45 Our findings revealed that MBC was not associated with elevated prevalence of HBV infection, which was in line with previous studies that HBV was not a breast cancer risk factor.…”

“… 43 Xiao et al demonstrated that chronic HBV infection predicts a worse prognosis in stage II/III BC patients, but not stage I BC. 16 However, Gao et al 52 and Yu et al 48 respectively found that HBV infection had no association with DFS and OS of breast cancer patients. In the present study, we found that HBV infection did not influence the survival of MBC, no matter in patients with de novo or relapsed metastatic disease.…”

“… 48 On the contrary, Xiao et al found that HBV infection did not independently affect HMFS of patients with non-metastatic breast cancer. 16 Li et al reported that, for very young patients with curatively resected breast cancer, HBsAg did not increase the rate of liver metastases. 43 The results of current study provide the first evidence that HBV infection does not impact the rate of intrahepatic and extrahepatic metastasis in MBC.…”

“…To some extent, these results were consistent with the other study, which showed that young breast cancer was associated with an increased prevalence of HBV infection. 16 , 17 …”

A Nomogram for Predicting Liver Metastasis of Lymph-Node Positive Luminal B HER2 Negative Subtype Breast Cancer by Analyzing the Clinicopathological Characteristics of Patients with Breast Cancer

“…Notably, based on the collected data from northwest China, these patients include those with better economic status, medical insurance, and educational level, and mostly belonging to the higher-income population, while the data from southeast China, which is densely populated, showed both rich and poor patient distribution with a higher proportion of patients with hepatitis B, 31 which may lead to a low probability of LM in northwest China. Currently, a model based on treatment and prevention of complications has been considered an important strategy in medical practice to identify those most likely to benefit from treatment interventions and cure liver disease, the patients in our study were more likely to have variant potential etiology of LM with the residence of northwest-southeast differences in China 31 , 32 since concurrent liver-related disease could attribute to the LM. 33 – 35 Recent guidelines describe PR-tumors as having a unique molecular signature and therefore, possess a particular therapeutic response to ET compared with PR + BC.…”