Burden Of Metastatic Breast Cancer Research Articles

POSC129 Economic Burden of Metastatic Breast Cancer in Greece

Breast cancer (BC) is the most commonly diagnosed cancer in women and the second leading cause of cancer death in Greece. The economic burden of BC is substantial and has been steadily increasing. The aim of this study was to provide the first estimate on the direct costs associated with the management of metastatic BC (mBC) in Greece.

An evaluation of the healthcare costs of metastatic breast cancer: A retrospective matched cohort study.

To determine the economic burden of metastatic breast cancer (MBC) in Taiwan, we conducted a national retrospective claim database analysis to evaluate the incremental healthcare costs and utilization of MBC patients as compared to their breast cancer (BC) and breast cancer free (BCF) counterparts.Data were obtained from the National Health Insurance Claim Database and the Taiwan Cancer Registry database between 2012 and 2015. All healthcare utilization and costs were calculated on a per-patient-per-month (PPPM) basis and were compared among groups using the generalized linear model adjusting for age group, residential area, and Charlson comorbidity index group.A total of 1,606 MBC patients were matched to 6,424 BC patients and 6,424 BCF patients. The majority of overall MBC healthcare costs were attributed to outpatient costs (75.1%), followed by inpatient (23.2%) and emergency room costs (1.7%). The PPPM total healthcare costs of the MBC, BC, and BCF groups were TWD 7,422, 14,425, and 2,114, respectively. The adjusted PPPM total healthcare cost ratio of MBC to BCF was 4.1. Compared to BCF patients, the patients receiving both human epidermal growth factor receptor 2-targeted therapy and endocrine therapy incurred 28.1 times PPPM total costs. The adjusted PPPM total healthcare cost ratio of recurrent MBC to BCF was 2.3, while the ratio was 12.2 in the de novo MBC group.Patients with MBC are associated with substantial economic burden, particularly in outpatient costs. The study findings could be useful for MBC-related economic evaluations and health resource allocation.

Abstract P1-18-17: The economic burden of HER2-targeted therapy among metastatic breast cancer patients

Abstract Background: There is limited information on the burden of metastatic breast cancer (mBC) with a central nervous system (CNS) metastasis in the literature. The objective of this study was to quantify the total all-cause healthcare resource utilization (HCRU) and costs among adult mBC patients administered HER2-targeted therapy with/without a CNS metastasis. Methods: Retrospective study included continuously enrolled patients with a diagnosis (ICD-9 / ICD-10 codes) of BC and mBC (stage III/IV metastasis) and a pharmacy claim of anti-HER2 therapy (index date) between 1/1/12-9/30/17 identified from IQVIA’s Real World Adjudicated Claims – US Database. After excluding patients with breast-related surgery and radiation procedure in the 6-month baseline period, 3 mutually exclusive treatment groups were created: trastuzumuab (T), T + chemotherapy (TC [including capecitabine or taxanes]) and lapatinib group (L [with or without chemotherapy]), each further stratified by presence/absence of CNS metastasis (identified by diagnosis codes/brain radiation procedures). Overall treatment groups were propensity score matched 1:1:1. All-cause HCRU and costs were evaluated over the 1-year follow-up period. Results: 5,895 HER2-targeted therapy patients were initially identified with 172 patients in each of the 3 treatment groups post-matching. Among these patients, 56.4%, 57.6% and 59.3% patients had a CNS metastasis in T, TC and L groups, respectively. The mean overall age of patients was 52.8, 52.3 and 52.6 years in T, TC and L groups, respectively, with a higher proportion of patients in the 55-64 age group. Majority of patients had arthritis/pain and cardiovascular diseases or were de novo metastatic in the baseline period. Baseline mean all-cause total costs were $77,069 among T group (CNS: $83,164; no CNS: $69,186), $62,164 among TC group (CNS: $66,906; no CNS: $55,733) and $81,007 among L group (CNS: $95,803; no CNS: $59,447). Costs were mainly driven by pharmacy (Rx)/outpatient (OP) setting. Over the 1-year follow-up period, mean total Rx costs were $115,453 (mean visits: 86.3), $81,091 (mean visits: 127.1) and $119,319 (mean visits: 83.3) among T, TC and L groups, respectively. This was followed by OP costs with $45,498 (mean visits: 189.2) in T, $62,263 (mean visits: 259.8) in TC and $69,654 (mean visits: 196.6) in L group. Inpatient (IP) costs were $13,319 (average hospital length of stay (LOS): 2.9 days), $18,177 (LOS: 2.2 days) and $10,239 (LOS: 1.4 days) among T, TC and L groups, respectively. CNS patients had higher mean total costs compared to the no CNS group among these treatment groups (T: $192,252 vs $153,784; TC: $237,376 vs $221,647 amd L: $205,637 vs $191,219). Conclusions: Costs among mBC patients administered HER2-targeted therapy were highest for Rx, followed by OP and then IP over the 1-year follow-up period. Among each of the treatment groups, CNS metastasis patients incurred higher costs compared to patients without a CNS metastasis. Table 1: HCRU and CostsCosts/HCRU (Mean (SD))T TC L Overall (172)CNS (97)No CNS (75)Overall (172)CNS (99)No CNS (73)Overall (172)CNS (102)No CNS (70)Total costs ($)175,479 (110,859)192,252 (117,801)153,784 (97,728)230,700 (118,127)237,376 (104,470)221,647 (134,688)199,769 (128,546)205,637 (123,428)191,219 (136,112)Rx visits86.3 (59.9)91.4 (66.0)79.6 (50.6)127.1 (51.4)130.5 (52.9)122.4 (49.3)83.3 (60.0)83.7 (60.5)82.6 (59.6)Total Rx costs ($)115,435 (90,443)118,388 (93,686)111,616 (86,543)149,609 (87,173)149,154 (84,852)150,226 (90,814)119,319 (99,587)119,754 (95,819)118,687 (105,539)OP visits189.2 (107.8)213.0 (119.0)158.4 (82.4)259.8 (97.5)269.6 (99.0)246.5 (94.5)196.6 (109.9)197.7 (102.1)195.0 (121.1)Total OP costs ($)45,498 (36,510)54,805 (41,792)33,462 (23,539)62,263 (40,151)69,685 (40,531)52,198 (37,607)69,654 (67,930)74,504 (68,010)62,588 (67,676) Citation Format: Andres Forero-Torres, Vamshi Ruthwik Anupindi, Jason Yeaw, Mitch DeKoven, Joseph Feliciano, Akshara Richhariya. The economic burden of HER2-targeted therapy among metastatic breast cancer patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-18-17.

Abstract P6-11-18: Medical, financial and insurance related concerns of metastatic breast cancer patients

Abstract Background: The medical, financial and insurance concerns of patients throughout the cancer trajectory are well documented. Over a quarter of patients report at least one financial problem. Due to the financial burden of cancer care, patients report that they delay filling prescriptions, have difficulty making ends meet, are concerned about their household’s financial situation and skip doses of medication. These are significant findings as consistent use of medication is necessary for treatment and those with increased financial problems also have lower scores on physical and mental health quality of life measures. While most providers agree that the burden of metastatic breast cancer (MBC) is also significant, little information is known about the specific medical, financial and insurance needs of those with MBC. Methods: Saint Luke’s Cancer Institute (SLCI) employs providers in the fields of medical and surgical oncology, gynecologic oncology, hematology and radiation oncology who subspecialize in every type of cancer. In October of 2016, the Koontz Center for Advanced Breast Cancer was established within the Saint Luke’s Cancer Institute. This center focuses exclusively on patients with MBC with a dual focus of improving outcomes and quality of life of those with MBC. In addition to a robust therapeutic research program, genomics, and immunotherapy, a comprehensive supportive/integrative team, including social worker, is imbedded in the center. Social workers see patients throughout the entirety of SLCI and the Koontz Center for Advanced Breast Cancer. As part of their patient interactions, social workers document the date of intervention, patients’ name, concern addressed, and length of every interaction. The following data compares the reported needs of those with MBC in the Koontz Center for Advanced Breast Cancer to the non-MBC patients within the SLCI population from September 1st of 2017 to August 31st of 2018. Results: In total, there were 2,072 interactions with non-MBC patients during this period. The top three reported concerns were medication assistance (n=335, 16.15%), being uninsured (n=298, 14.37%) and transportation (n=284, 13.69%). For those with MBC, there were a total of 476 interactions within the same time frame and the top three reported concerns were medication assistance (n=166, 34.87%), insurance issues (n=75, 15.76%) and financial distress (n=66, 13.87%). About 55% of non-MBC patients (n=334, 55.95%) have repeat appointments and meet with social work on average 5 times. Of MBC patients, 60.67% (n=54) have repeat appointments and meet with social work on average 7 times. For one time encounters with social work, those with non-MBC patients lasted 21 minutes and 9 seconds and encounters with MBC patients lasted 24 minutes and 34 seconds. Conclusion: Results indicate differences and similarities for MBC patients compared to non-MBC patients. This could be explained by the fact that both populations share several concerns such as financial barriers to medications, high insurance premiums and decreased ability to work. However, due to the nature of MBC, patients with MBC often deal with these concerns for longer periods of time and are often required to utilize expensive specialty medication. The top three concerns of MBC patients including medication assistance, insurance issues, and financial distress, are closely related to one another as it relates to gaps in healthcare coverage. The high cost of treatment for advanced disease, coupled with the specific and unique needs of those living with MBC, can directly impact patients’ ability to access necessary care. These potential causes, as well as how the Koontz Center for Advanced Breast Cancer works to mitigate these issues, will be addressed in further detail. Citation Format: Savannah Joy Geske, Katie Ambrosier, Timothy J. Pluard. Medical, financial and insurance related concerns of metastatic breast cancer patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-11-18.

PCN27 - Evaluation of the Healthcare Costs and Utilization of Patients with Metastatic Breast Cancer

To determine the economic burden of metastatic breast cancer (MBC) in Taiwan, we conducted a national retrospective study to evaluate the incremental healthcare costs and utilization of MBC patients as compared to their breast cancer (BC) and breast cancer free (BCF) counterparts. Data were obtained from the Longitudinal Health Insurance Database (LHID) and the Taiwan Cancer Registry database between 2012 to 2015. Patients with MBC were identified by (1) the 7th Edition of cancer staging system of the American Joint Committee on Cancer (AJCC), and (2) having at least one diagnosis of secondary malignant neoplasm in a claim. The identified MBC patients were then matched with BC and BCF patients on a 1:2:2 basis by age, gender, residential region, and the Charlson Comorbidity Index. Each selected beneficiary was then followed from the index date (i.e., first diagnosis of BC/MBC or a random date in 2012 for the BCF group) to death or December 31, 2015, the censoring date. All healthcare utilization and costs were calculated on a per person per month (PPPM) basis. A total of 2,637 MBC patients were identified and matched to 5,274 BC patients and 5,274 BCF patients. MBC patients had significantly greater healthcare utilization than the other two groups, with an average of 0.2/8.3/0.1 inpatient/outpatient/ER monthly visits, compared to 0.2/7.2/0.1 visits in the BC group and 0.1/5.5/0.1 visits in the BCF group. In addition, the mean total healthcare monthly costs of MBC, BC, and BCF group were NTD$85,146.9, $21,310.4, and $9,293.3, respectively. Outpatient, inpatient, emergency room, and total medication costs accounted for 40.8%, 39.2%, 20.1%, and 29.7% of MBC total healthcare costs, respectively. Patients with MBC are associated with substantial economic burden. The study findings could be useful for MBC-related economic evaluations and health resource allocation.

The economic burden of metastatic breast cancer in Spain

ObjectivesThe study aimed to estimate the burden of metastatic breast cancer (mBC) in Spain over 5 years.MethodsAn incidence-based cost-of-illness model was developed in which a cohort of patients with mBC...

Co-chaperone BAG2 Determines the Pro-oncogenic Role of Cathepsin B in Triple-Negative Breast Cancer Cells

Triple-negative breast cancer (TNBC) is considered incurable with currently available treatments, highlighting the need for therapeutic targets and predictive biomarkers. Here, we report a unique role for Bcl-2-associated athanogene 2 (BAG2), which is significantly overexpressed in TNBC, in regulating the dual functions of cathepsin B as either a pro- or anti-oncogenic enzyme. Silencing BAG2 suppresses tumorigenesis and lung metastasis and induces apoptosis by increasing the intracellular mature form of cathepsin B, whereas BAG2 expression induces metastasis by blocking the auto-cleavage processing of pro-cathepsin B via interaction with the propeptide region. BAG2 regulates pro-cathepsin B/annexin II complex formation and facilitates the trafficking of pro-cathespin-B-containing TGN38-positive vesicles toward the cell periphery, leading to the secretion of pro-cathepsin B, which induces metastasis. Collectively, our results uncover BAG2 as a regulator of the oncogenic function of pro-cathepsin B and a potential diagnostic and therapeutic target that may reduce the burden of metastatic breast cancer.

PRM19 - Time Dependent Resource Use and Costs Associated with Different States of Disease in Patients Diagnosed with HER-2 Positive Metastatic Breast Cancer

Adequate reflection of disease progression and costs over time is essential in cost-effectiveness analyses based on health state-transition models. However, costing studies normally investigate the burden of metastatic breast cancer (MBC) without explicitly examining the impact of specific-disease states on health care costs over time. The objective of this study was to assess time-dependent costs of different health states of human epidermal receptor-2 (HER-2) positive MBC and the factors contributing to these costs. In the Netherlands, HER-2-positive MBC patients were identified in three different hospitals. Resource use was collected during 24 months, which was linked to unit costs and related to time with respect to date of MBC diagnosis, disease progression and death for each individual patient. Subsequently, monthly costs for different health states were calculated. Finally, a nonlinear mixed-effect modelling approach was used to provide a quantitative description of the time course of cumulative progression costs. Costs during stable disease were constant over time with a mean of $4,158. In contrast, monthly costs for progressive disease demonstrated a change over time with the largest costs in the first 2 months after diagnosis (p < 0.005). The developed mixed-effect model adequately described cumulative cost-time course and associated variability. During the last months of life, costs varied over time, with the last month of life as the most expensive one with a mean of $5,811 per patient per month. To reflect costs of HER-2-positive MBC accurately in Markov models, costs for stable disease can be defined time independent, however, costs of progressive disease should be defined time dependent, and costs related to the final months of life should be modelled as such. The mixed-effect model we have developed could now be considered for adequate description of the time-dependent cost of progressive disease.

Indirect costs associated with metastatic breast cancer

Objective:To compare the indirect costs of productivity loss between metastatic breast cancer (MBC) and early stage breast cancer (EBC) patients, as well as their respective family members.Methods:The MarketScan® Health and Productivity Management database (2005–2009) was used. Adult BC patients eligible for employee benefits of sick leave and/or short-term disability were identified with ICD-9 codes. Difference in sick leave and short-term disability days was calculated between MBC patients and their propensity score matched EBC cohort and general population (controls) during a 12-month follow-up period. Generalized linear models were used to examine the impact of MBC on indirect costs to patients and their families.Results:A total of 139 MBC, 432 EBC, and 820 controls were eligible for sick leave and 432 MBC, 1552 EBC, and 4682 controls were eligible for short-term disability (not mutually exclusive). After matching, no statistical difference was found in sick leave days and the associated costs between MBC and EBC cohorts. However, MBC patients had significantly higher short-term disability costs than EBC patients and controls (MBC: $6166 ± $9194 vs EBC: $3690 ± $6673 vs Controls: $558 ± $2487, both p < 0.001). MBC patients had more sick leave cost than controls ($2383 ± $5539 vs $1282 ± $2083, p < 0.05). Controlling for covariates, MBC patients incurred 47% more short-term disability costs vs EBC patients (p = 0.009). Older patients (p = 0.002), non-HMO payers (p < 0.05), or patients not receiving chemotherapy during follow-up (p < 0.001) were associated with lower short-term disability costs. MBC patients’ families incurred 39.7% (p = 0.06) higher indirect costs compared to EBC patients’ families after controlling for key covariates.Conclusion:Productivity loss and associated costs in MBC patients are substantially higher than EBC patients or the general population. These findings underscore the economic burden of MBC from a US societal perspective. Various treatment regimens should be evaluated to identify opportunities to reduce the disease burden from the societal perspective.

Time-dependent resource use and costs associated with different states of disease in patients diagnosed with HER-2-positive metastatic breast cancer

Adequate reflection of disease progression and costs over time is essential in cost-effectiveness analyses based on health state-transition models. However, costing studies normally investigate the burden of metastatic breast cancer (MBC) without explicitly examining the impact of specific-disease states on health care costs over time. The objective of this study was to assess time-dependent costs of different health states of human epidermal receptor-2 (HER-2) positive MBC and the factors contributing to these costs. In the Netherlands, HER-2-positive MBC patients were identified in three different hospitals. Resource use was collected during 24 months, which was linked to unit costs and related to time with respect to date of MBC diagnosis, disease progression and death for each individual patient. Subsequently, monthly costs for different health states were calculated. Finally, a nonlinear mixed-effect modelling approach was used to provide a quantitative description of the time course of cumulative progression costs. Costs during stable disease were constant over time with a mean of $4,158. In contrast, monthly costs for progressive disease demonstrated a change over time with the largest costs in the first 2 months after diagnosis (p < 0.005). The developed mixed-effect model adequately described cumulative cost-time course and associated variability. During the last months of life, costs varied over time, with the last month of life as the most expensive one with a mean of $5,811 per patient per month. To reflect costs of HER-2-positive MBC accurately in Markov models, costs for stable disease can be defined time independent, however, costs of progressive disease should be defined time dependent, and costs related to the final months of life should be modelled as such. The mixed-effect model we have developed could now be considered for adequate description of the time-dependent cost of progressive disease.

Locally recurrent or metastatic breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Locally recurrent or metastatic breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Indirect costs associated with metastatic breast cancer.

74 Background: To estimate indirect costs (sick leave [SL]/short-term disability [STDI]) associated with metastatic breast cancer (MBC) compared to early stage breast cancer (EBC)/a general population without cancer (controls). Methods: The MarketScan Health and Productivity Management database (2005-2009) was used. Adult BC patients eligible for employee benefits of sick leave and/or STDI were identified. Difference in SL and STDI days was calculated between MBC patients and their propensity score matched EBC cohort or controls during a 12-month follow-up period. Indirect costs due to SL/ STDI were estimated by multiplying leave days with daily wages (2011 Bureau of Labor Statistics). Generalized linear model was used to examine the impact of MBC on indirect costs and potential cost drivers. Results: A total of 139 MBC/432 EBC/820 controls and 432 MBC/1,552 EBC/4,682 controls were eligible for SL and STDI respectively (not mutually exclusive), with a mean age of 49/51/50 years. After matching by age, payer type, region, index year and comorbidities, no difference was found in SL days between MBC and EBC cohorts. MBC patients had more STDI days and related cost than EBC patients and controls, with higher total indirect costs (SL + STDI). MBC patients also had more SL days/cost than controls (Table). Controlling for covariates, MBC patients incurred 47% more STDI cost vs. EBC patients (p=.009). Older patients (p=.002), non-HMO payers (p&lt;.05), or patients not receiving chemotherapy during follow-up (p&lt;.001) were associated with lower STDI cost. MBC patients also incurred 56% (p=.01) more SL cost and 11.6 times (p&lt;.001) more STDI cost than controls. Conclusions: Productivity loss and associated costs in MBC patients are substantially higher than EBC patients or general population. These findings underscore the economic burden of MBC from US societal perspective. [Table: see text]

The economic burden of metastatic breast cancer: a U.S. managed care perspective

This study was performed to quantify the economic burden and identify drivers of direct costs of mBC. In a retrospective study of a de-identified administrative claims database of privately insured patients, women between 18 and 64 years of age were included if they had at least one claim with a diagnosis of breast cancer and subsequently one or more claims with a diagnosis of secondary malignancy between January 1, 2003 and December 31, 2009. The study sample was further classified into the following subgroups: (1) Endocrine therapy, (2) HER-2 targeted therapy, (3) Concomitant HER-2 targeted and endocrine therapy, (4) Cytotoxic chemotherapy, and (5) No-systemic therapy. Costs for medical resource utilization were calculated on a per patient per month (PPPM) basis. A total of 7,698 mBC patients were identified from 2003 to 2009 with an average age at index of ~52 years, and average follow up of 2.2 years. The average total direct medical costs for 7,698 mBC patients were $9,788 PPPM. Outpatient costs accounted for the majority of overall PPPM costs. Examining the five different mBC therapeutic subgroups revealed that patients who received no-systemic therapy had the highest costs at $13,926 PPPM, while patients who received systemic endocrine therapy had the lowest costs at $5,303 PPPM. This study demonstrated that mBC is associated with substantial healthcare costs in a non-Medicare patient population. Assuming average PPPM costs of $9,788 and an average life expectancy of 2.2 years, the total average expenditure to treat mBC would be ~$250,000 per patient.

Importance of Providing Tailored Resources to Patients with Metastatic Breast Cancer: Results of the Global BRIDGE Survey.

Abstract IntroductionLife expectancy for women with metastatic breast cancer (MBC) has increased as advances have been made in treatment and management. Consequently, when measuring the burden of MBC, womens' experiences, quality of life, and gaps in information and support needs should be considered. The BRIDGE Survey (Bridging Gaps, Expanding Outreach – Metastatic Breast Cancer Patient Survey) was conducted in the US, Europe, Latin America and Africa to evaluate patients' (pts) own perceptions of living with MBC; results are presented here.MethodsA Steering Committee of 3 international oncology thought leaders, 4 pt advocates, and a global public health organization was set up with the support of Pfizer Inc. to develop a quantitative survey (Harris Interactive®). To provide a balance between low and high-resource countries, women in the US, UK, France, Spain, Poland, Belgium, Argentina, Mexico, and Egypt aged ≥18 years with stage IV/metastatic disease were recruited and interviewed. Survey methods included telephone, mail, and in-person interviews, dependent on country and pt preference. The 34-item questionnaire took ∼25-mins to complete. Topics included MBC resources, support networks, attention given to MBC vs. early breast cancer (EBC) and personal impact of the disease. Pts were also asked if they had ever participated in, or searched for information about, clinical trials.ResultsIn total, 950 women completed the survey, referred by ∼20 physicians in each of the 9 participating countries. Most women (53%) felt that MBC was given too little consideration compared with EBC. 75% actively sought information on MBC but 51% felt that available information did not address their needs. Written materials were most frequently used, although many women found the internet most helpful. Those women who sought information were more likely to take an active role in treatment decisions and be more optimistic in outlook. Globally, 18% of women reported that they had participated in a clinical trial, with encouragement to do so by a healthcare professional being the most common reason given (77%). Numerous country-specific differences were observed, most notably in ease of finding information, whether available information meets pt needs, need for medical vs. non-medical information, and clinical trial participation. There were also country-specific differences in womens' level of optimism on diagnosis.ConclusionsThese results suggest that women with MBC have different needs from those of pts with EBC and that these needs are not always being met. Women are asking for information relevant both to their culture and to their disease stage. Further results will be presented, and will be discussed in the context of a recently published MBC Consensus Report compiled by the MBC Advocacy Working Group (Community Oncology 2008;5[12]; Breast 2009 [In Press]). Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3085.

Secondary malignancies developing during metastatic breast cancer treatment

e12020 Background: Secondary malignancies (SM) developing during metastatic breast cancer (MBC) are obviously more complicated for diagnosis, potential surgery and for further MBC treatment. However, the frequency of SM during MBC is not well explored, in contrast to SM after nonmetastatic BC. The aim of this paper is to determine frequency of SM in MBC patients and to determine the percentage of surgically treated SM. Methods: Hospital charts of BC patients were retrospectively analyzed at the Institute for Oncology and Radiology of Serbia. Patients who developed SM at any time point after BC were included in this analysis. Patients with contra-lateral BC and acute leukemia were excluded. Patients with SM during MBC were separately analyzed. Results: A cohort of 50 BC patients with SM was identified. Median age was 50 (range 32–78 years) median time to SM was 65.3 months (range 1–276). Forty-six patients had histological confirmation of SM. In 30 patients SM developed during treatment for MBC. Four SM were not confirmed by biopsy due to SM site or high burden of MBC. Median age was 53.4 years (range 34–74), median time to SM development was 78.9 months, and median time to BC metastases was 60.1 months. The most frequent SM in MBC patient were lung (5), endometrial (4, all treated with tamoxifen), ovarian (3), thyroid (3), cervical (3), and colon carcinoma (2). Only 14 patients with SM (14/30: 46%) could be treated with radical surgery and SM did not influenced further MBC treatment. Conclusions: According to our experience, SM develops more frequently in MBC than in non MBC patients, representing 60% (30/50 patients) of all SM in BC patients; 46.6% (14/30) of SM diagnosed during MBC could be surgically resected, and does not influence further MBC treatment. No significant financial relationships to disclose.