Analysis of the first metastasis pattern and prognostic factors of 147 patients with metastatic breast cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TAN Lingzhen , XU Zhiliang ,  SUN Shengrong

Department of Breast and Thyroid Surgery, People's Hospital of Wuhan University, Wuhan 430060, R. P. China;

Corresponding?author：

SUN Shengrong, Email: sun137@sina.com

Keywords：

advanced breast cancer; metastasis; prognosis

DOI：

10.7507/1007-9424.201909020

Video：

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Objective To study on the first metastasis pattern and prognostic factors in patients with recurrent and metastatic breast cancer.Methods The study selected 147 patients with metastatic breast cancer who were diagnosed for the first time in the Breast Thyroid Center and Oncology Department, the People's Hospital of Wuhan University from June 2016 to June 2018. The model of first metastasis and the first diagnosis of prognosis may be affected. The age at diagnosis of breast cancer, tumor size, lymph node metastasis, hormone receptor status, HER-2 status, number of metastatic organs, tumor location, molecular typing, etc. were retrospective analyzedResults The most common metastatic sites for breast cancer was bone metastases in 55 patients (37.41%), followed by lung metastasis and liver metastases, 29 (19.73%) and 24 (16.33%), respectively. Univariate analysis showed that the number of lymph node metastasis, HER-2 status, organ number of first-time metastasis, and endocrine therapy were significant factors affecting metastatic survival time, and the difference was statistically significant (P<0.05). Multivariate analysis showed that the number of lymph node metastasis, the number of metastatic organs and HER-2 were independent risk factors for advanced breast cancer (P<0.05).Conclusions The most common metastasis of breast cancer patients after surgery is bone, followed by lung metastasis and liver metastasis. The number of lymph node metastases, the number of metastatic organs, HER-2 status, and endocrine therapy are independent factors influencing the prognosis of patients with recurrent metastasis.

Citation： TAN Lingzhen, XU Zhiliang, SUN Shengrong. Analysis of the first metastasis pattern and prognostic factors of 147 patients with metastatic breast cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(7): 814-818. doi: 10.7507/1007-9424.201909020 Copy

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2.	Gonzalez-Angulo AM, Morales-Vasquez F, Hortobagyi GN. Overview of resistance to systemic therapy in patients with breast cancer. Adv Exp Med Biol, 2007, 608: 1-22.
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6.	Shim HJ, Kim SH, Kang BJ, et al. Breast cancer recurrence according to molecular subtype. Asian Pac J Cancer Prev, 2014, 15(14): 5539-5544.
7.	Schr?der J, Fietz T, K?hler A, et al. Treatment and pattern of bone metastases in 1 094 patients with advanced breast cancer - Results from the prospective German Tumour Registry Breast Cancer cohort study. Eur J Cancer, 2017, 79: 139-148.
8.	Martin TJ, Moseley JM. Mechanisms in the skeletal complications of breast cancer. Endocr Relat Cancer, 2000, 7(4): 271-284.
9.	Selzner M, Morse MA, Vredenburgh JJ, et al. Liver metastases from breast cancer: long-term survival after curative resection. Surgery, 2000, 127(4): 383-389.
10.	Chung CT, Carlson RW. Goals and objectives in the management of metastatic breast cancer. Oncologist, 2003, 8(6): 514-520.
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14.	喬洪潔, 叢慶華. 乳腺癌與乳腺良性腫瘤患者術前心理社會因素比較. 中國醫院統計, 2013, 20(6): 431-433.
15.	Herbert C, Nichol A, Olivotto I, et al. The impact of hypofractionated whole breast radiotherapy on local relapse in patients with Grade 3 early breast cancer:a population-based cohor study. Int J Radiat Oncol Biol Phys, 2012, 82(5): 2086-2092.
16.	淦錦, 黃桂林, 李志剛, 等. 乳腺癌改良根治術后復發轉移相關因素. 中華實用診斷與治療雜志, 2013, 27(1): 33-35.
17.	高鵬, 周庚寅, 魏軍民, 等. 乳腺癌 C-erbB2 過表達與生存率、內分泌治療效果和預后的關系. 中國普通外科雜志, 2003, 10(3): 357-359.
18.	Kennecke H, Yerushalmi R, Woods R, et al. Metastatic behavior of breast cancer subtypes. Clin Oncol, 2010, 28(20): 3271-3277.
19.	Staaf J, Ringnér M, Vallon-Christersson J, et a1. Identification of subtypes in human epidermal growth factor receptor 2—positive breast cancer reveals a gene signature prognostic of outcome. Clin Oncol, 2010, 28(11): 1813-1820.
20.	Milanezi F, Carvalho S, Schmitt FC. EGFR/HER2 in breast cancer: a biological approach for molecular diagnosis and therapy. Expert Rev Mol Diagn, 2008, 8(4): 417-434.
21.	汪波, 管忠震, 劉冬耕, 等. 雌、孕激素受體及 HER-2 受體在乳腺癌原發灶及復發轉移灶之間的表達差異. 癌癥, 2004, 23(12): 1710-1713.
22.	Li ZH, Hu PH, Tu JH, et al. Luminal B breast cancer:patterns of recurrence and clinical outcome. Oncotarget, 2016, 7(40): 65024-65033.
23.	江澤飛, 陳佳藝, 牛曉輝, 等. 乳腺癌骨轉移和骨相關疾病臨床診療專家共識(2014 版). 中華醫學雜志, 2015, 95(4): 241-247.
24.	Ozawa H, Sata A, Fukui R. A single-centre, rertrospective observational analysis of fulvestrant for recurrent/metatastaic breast cancer according to metastatic site. Anticancer Res, 2019, 39(11): 5653-5662.
25.	Gennari A, D'amico M, Corradengo D. Extending the duration of first-line chemotherapy in metastatic breast cancer: a perspective review. Ther Adv Med Oncol, 2011, 3(5): 229-232.
26.	周毅, 周勤. 諾維本加鉑類二線化療治療老年復發轉移性乳腺癌的療效. 中國老年學雜志, 2013, 33(1): 204-205.
27.	夏金, 陳瑞萍, 張彥芳, 等. 諾維本聯合鉑類二線化療治療老年復發轉移性乳腺癌的療效分析. 腫瘤藥學, 2015, 5(3): 209-212.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin, 2016, 66(1): 7-30.
2. Gonzalez-Angulo AM, Morales-Vasquez F, Hortobagyi GN. Overview of resistance to systemic therapy in patients with breast cancer. Adv Exp Med Biol, 2007, 608: 1-22.
3. Siegel RL, Miller KD, Jemal A. Cancer statistics 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
4. 徐冰河, 江澤飛, 胡夕春. 中國晚期乳腺癌臨床診療專家共識 2016. 中華醫學雜志, 2016, 22(96): 1719-1727.
5. 王芳, 郝春芳, 賈勇圣, 等. 205 例初治轉移性乳腺癌的臨床病理特點和生存分析. 中國腫瘤臨床, 2014, 41(17): 1103-1107.
6. Shim HJ, Kim SH, Kang BJ, et al. Breast cancer recurrence according to molecular subtype. Asian Pac J Cancer Prev, 2014, 15(14): 5539-5544.
7. Schr?der J, Fietz T, K?hler A, et al. Treatment and pattern of bone metastases in 1 094 patients with advanced breast cancer - Results from the prospective German Tumour Registry Breast Cancer cohort study. Eur J Cancer, 2017, 79: 139-148.
8. Martin TJ, Moseley JM. Mechanisms in the skeletal complications of breast cancer. Endocr Relat Cancer, 2000, 7(4): 271-284.
9. Selzner M, Morse MA, Vredenburgh JJ, et al. Liver metastases from breast cancer: long-term survival after curative resection. Surgery, 2000, 127(4): 383-389.
10. Chung CT, Carlson RW. Goals and objectives in the management of metastatic breast cancer. Oncologist, 2003, 8(6): 514-520.
11. Er O, Frye DK, Kau SW, et al. Clinical course of breast cancer patients with metastases limited to the liver treated with chemotherapy. Cancer, 2008, 14(1): 62-68.
12. Aders CK, Deal AM, Miller CR, et al. The prognostic contribution of clinical breast cancer subtype, age, and race among patients with breast cancer brain metastases. Cancer, 2011, 117(8): 1602-1611.
13. Hatoum HA, Jamali FR, El-Saghir NS, et al. Ratio between positive lymph nodes and total excised axillary lymph nodes as an independent prognostic factor for overall suivival in patients with nonmetastatic lymph node-positive breast cancer. Indian J Surg Oncol, 2010, 1(4): 305-312.
14. 喬洪潔, 叢慶華. 乳腺癌與乳腺良性腫瘤患者術前心理社會因素比較. 中國醫院統計, 2013, 20(6): 431-433.
15. Herbert C, Nichol A, Olivotto I, et al. The impact of hypofractionated whole breast radiotherapy on local relapse in patients with Grade 3 early breast cancer:a population-based cohor study. Int J Radiat Oncol Biol Phys, 2012, 82(5): 2086-2092.
16. 淦錦, 黃桂林, 李志剛, 等. 乳腺癌改良根治術后復發轉移相關因素. 中華實用診斷與治療雜志, 2013, 27(1): 33-35.
17. 高鵬, 周庚寅, 魏軍民, 等. 乳腺癌 C-erbB2 過表達與生存率、內分泌治療效果和預后的關系. 中國普通外科雜志, 2003, 10(3): 357-359.
18. Kennecke H, Yerushalmi R, Woods R, et al. Metastatic behavior of breast cancer subtypes. Clin Oncol, 2010, 28(20): 3271-3277.
19. Staaf J, Ringnér M, Vallon-Christersson J, et a1. Identification of subtypes in human epidermal growth factor receptor 2—positive breast cancer reveals a gene signature prognostic of outcome. Clin Oncol, 2010, 28(11): 1813-1820.
20. Milanezi F, Carvalho S, Schmitt FC. EGFR/HER2 in breast cancer: a biological approach for molecular diagnosis and therapy. Expert Rev Mol Diagn, 2008, 8(4): 417-434.
21. 汪波, 管忠震, 劉冬耕, 等. 雌、孕激素受體及 HER-2 受體在乳腺癌原發灶及復發轉移灶之間的表達差異. 癌癥, 2004, 23(12): 1710-1713.
22. Li ZH, Hu PH, Tu JH, et al. Luminal B breast cancer:patterns of recurrence and clinical outcome. Oncotarget, 2016, 7(40): 65024-65033.
23. 江澤飛, 陳佳藝, 牛曉輝, 等. 乳腺癌骨轉移和骨相關疾病臨床診療專家共識(2014 版). 中華醫學雜志, 2015, 95(4): 241-247.
24. Ozawa H, Sata A, Fukui R. A single-centre, rertrospective observational analysis of fulvestrant for recurrent/metatastaic breast cancer according to metastatic site. Anticancer Res, 2019, 39(11): 5653-5662.
25. Gennari A, D'amico M, Corradengo D. Extending the duration of first-line chemotherapy in metastatic breast cancer: a perspective review. Ther Adv Med Oncol, 2011, 3(5): 229-232.
26. 周毅, 周勤. 諾維本加鉑類二線化療治療老年復發轉移性乳腺癌的療效. 中國老年學雜志, 2013, 33(1): 204-205.
27. 夏金, 陳瑞萍, 張彥芳, 等. 諾維本聯合鉑類二線化療治療老年復發轉移性乳腺癌的療效分析. 腫瘤藥學, 2015, 5(3): 209-212.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of the first metastasis pattern and prognostic factors of 147 patients with metastatic breast cancer

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