Patterns of distant metastasis in Chinese women according to breast cancer subtypes.

San-Gang Wu,Zhen-Yu He,Qin Lin,Jia-Yuan Sun,Li-Chao Yang,Li-Ying Tang,Xue-Ting Chen,Huan-Xin Lin,Gui-Hua Liu,Xue Wang

doi:10.18632/oncotarget.10099

Abstract

To access possible relationships between breast cancer subtypes (BCS) and patterns of distant metastasis in advanced breast cancer. Breast cancer patients with distant metastasis at two academic centers from 2000-2015 were retrospectively reviewed. The breast cancer was classified into four subtypes: hormone receptor (HR) +/ human epidermal growth factor receptor 2 (HER2) − (i.e., estrogen receptor [ER] + and/or progesterone receptor [PR] +, HER2−); HR+/HER2+ (ER+ and/or PR+, HER2+), HR−/HER2+ (ER− and PR−, and HER2+); and HR−/HER2− (ER− and PR−, and HER2−). A total of 679 patients were identified. The distribution of the BCS was 39.9% (271/679), 23.7% (161/679), 16.8% (114/679), and 19.6% (133/679) in HR+/HER2−, HR+/HER2+, HR−/HER2+, and HR−/HER2−, respectively. Patients with HR+/HER2+ and HR−/HER2+ subtypes were prone to abdominal and pelvic metastasis, those with HR+/HER2− and HR+/HER2+ subtypes were prone to bone metastasis, while patients with the HR−/HER2− subtype were prone to lung/mediastinal and brain metastases. In patients with pleural, axillary and/or neck lymph node, and other distant soft tissue metastases, there was no significant difference in metastatic patterns among the BCS. There are different patterns of distant metastasis associated with different BCS. There should be a different focus in the postoperative follow-up and monitoring of breast cancer patients with different BCS.

Highlights

Breast cancer is the most common malignancy in women worldwide
Patients with hormone receptor (HR)+/has been made in the www.impactjournals.com/oncotarget2 (HER2)+ and HR−/HER2+ subtypes were prone to abdominal and pelvic metastasis, those with HR+/HER2− and HR+/HER2+ subtypes were prone to bone metastasis, while patients with the HR−/HER2− subtype were prone to lung/
A heterogeneous disease composed of distinct biological subtypes, can be divided into four simple subtypes based on estrogen receptor (ER), progesterone receptor (PR) and HER2 status: hormone receptor (HR)+/HER2−, HR+/HER2+, HR−/HER+, and HR−/

Summary

Introduction

Breast cancer is the most common malignancy in women worldwide. It is estimated that there will be about 232,000 new cases of breast cancer diagnosed in the United States in 2015 [1]. In China, there is a rapid growth trend in breast cancer, and cancer prevalence estimates for 5 years are 1.02 million women with breast cancer [2]. Great progress has been made in the www.impactjournals.com/oncotarget. Traditional tumor-nodemetastasis (TNM)-staging may predict the risk of breast cancer metastasis and death, but the predictive value for specific sites of metastasis is poor. A heterogeneous disease composed of distinct biological subtypes, can be divided into four simple subtypes based on ER, PR and HER2 status: hormone receptor (HR)+/HER2−, HR+/HER2+, HR−/HER+, and HR−/

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Conclusion