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  • Retrospective analysis of m...
    Savci-Heijink, C. Dilara; Halfwerk, Hans; Hooijer, Gerrit K. J.; Horlings, Hugo M.; Wesseling, Jelle; van de Vijver, Marc J.

    Breast cancer research and treatment, 04/2015, Letnik: 150, Številka: 3
    Journal Article

    Among breast cancer patients who develop distant metastases, there is marked variability in the clinical course, including metastasis pattern. Here, we present a retrospective study of breast cancer patients who all developed distant metastases focusing on the association between breast cancer subtype and clinical course, including organ-specific metastasis. Tissue microarrays (TMAs) were assembled and stained for ER, PR, HER2, EGFR, CK5/6, CK14, E-Cadherin, TP53 and Ki67 for 263 breast cancer patients with metastatic disease. Tumours were classified into ER+/HER2− / Ki67high, ER+/HER2−/Ki67low, ER+/HER2+, ER−/HER2+ and ER−/HER2− groups. Relevant data related to metastasis pattern, metastasis timeline, systemic treatment and survival were retrieved. Associations between site-specific relapse and patient/tumour characteristics were assessed with multivariate models using logistic regression. Median time for development of distant metastasis was 30 months (range 0–15.3 years); 75.8 % of the distance metastases developed in the first 5 years after treatment of the primary tumour. Patients with ER−/HER2− tumours had a median overall survival of 27 months; those with HER2+ tumours of 52 months; those with ER+/HER2−/Ki67high of 76 months and those with ER+/HER2−/Ki67low of 79 months. Bone was the most common site for distant metastasis (70.6 %) followed by liver (54.5 %) and lung (31.4 %), respectively. Visceral metastasis was found in 76.8 % of the patients. Patients with ER−/HER2− tumours developed visceral metastases in 81 % and bone metastases in 55.2 %; those with HER2+ tumours developed visceral metastases in 77.4 % and bone metastases in 69.8 %; those with ER+/HER2−/Ki67high developed visceral metastases in 75.7 % and bone metastases in 87.8 % and those with ER+/HER2−/Ki67low developed visceral metastases in 76.9 % and bone metastases in 73.1 %. In metastatic breast cancer patients, tumour subtypes are associated with survival and pattern of distant metastases. These associations are of help in choices for surveillance and therapy in individual patients.