Abstract
BackgroundThe features and survival of stage IV breast cancer patients with different metastatic sites are poorly understood. This study aims to examine the clinicopathological features and survival of stage IV breast cancer patients according to different metastatic sites.MethodsUsing the Surveillance, Epidemiology, and End Results database, we restricted our study population to stage IV breast cancer patients diagnosed between 2010 to 2015. The clinicopathological features were examined by chi-square tests. Breast cancer-specific survival (BCSS) and overall survival (OS) were compared among patients with different metastatic sites by the Kaplan-Meier method with log-rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazard model to identify statistically significant prognostic factors.ResultsA total of 18,322 patients were identified for survival analysis. Bone-only metastasis accounted for 39.80% of patients, followed by multiple metastasis (33.07%), lung metastasis (10.94%), liver metastasis (7.34%), other metastasis (7.34%), and brain metastasis (1.51%). The Kaplan-Meier plots showed that patients with bone metastasis had the best survival, while patients with brain metastasis had the worst survival in both BCSS and OS (p < 0.001, for both). Multivariable analyses showed that age, race, marital status, grade, tumor subtype, tumor size, surgery of primary cancer, and a history of radiotherapy or chemotherapy were independent prognostic factors.ConclusionStage IV breast cancer patients have different clinicopathological characteristics and survival outcomes according to different metastatic sites. Patients with bone metastasis have the best prognosis, and brain metastasis is the most aggressive subgroup.
Highlights
The features and survival of stage IV breast cancer patients with different metastatic sites are poorly understood
Metastatic breast cancer is a heterogeneous disease with distinct prognoses [6], which are affected by many clinicopathological features of patients, such as age, race, marital status, performance status as well as tumor size, lymph nodes status, metastatic sites, number of metastatic sites, pathological or genotype characteristics and previous medical treatments [7,8,9]
The TNM stage is the widely accepted tool to predict the prognosis of patients, but it deals with a limited range of factors and ignores patient-specific conditions, pathological or genotype characteristics, and treatments [10]
Summary
The features and survival of stage IV breast cancer patients with different metastatic sites are poorly understood. This study aims to examine the clinicopathological features and survival of stage IV breast cancer patients according to different metastatic sites. It is estimated that 20–30% of early stage breast cancers will go on to develop metastatic disease, and 6–10% of all women suffering from breast cancer in the United States were found to have stage IV disease at diagnosis (called de novo metastatic breast cancer) [4]. These patients have poor prognoses with a median survival time of 2–3 years [5], despite technology development and. Among all the predictors of outcome mentioned above, the metastatic site may be the most important factor with the greatest significant impact on further treatment regimens
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