Abstract
Few contemporary data are available that compare incidence and survival of metastatic breast cancer between ductal and lobular carcinomas. Using the Surveillance, Epidemiology, and End Results-9 registries, we identified 10,639 patients with de novo metastatic breast cancer diagnosed from 1990 to 2011. Annual age-adjusted incidence rates and annual percent changes (APCs) were analyzed. Multivariable Cox regression models were used to investigate the impact of year of diagnosis and histology on overall survival. 9250 (86.9 %) patients had ductal and 1389 (13.1 %) had lobular carcinomas. Metastatic breast cancer incidence increased slightly over time for ductal (APC = +1.7, 95 % confidence interval (CI) = +1.0 to +2.4) and lobular carcinomas (APC = +3.0, 95 % CI = +1.8 to +4.3). Median overall survival was 22 months among the whole cohort. More recent year of diagnosis was associated with better overall survival only for patients with ductal carcinomas (interaction p value = 0.006), with an adjusted hazard ratio of death for every five-year increment in the date of diagnosis of 0.93 (95 % CI = 0.91–0.95) among ductal carcinomas, compared with 1.05 (95 % CI = 0.95–1.10) among lobular carcinomas. Overall survival was longer for lobular versus ductal carcinomas (28 versus 21 months, respectively; adjusted hazard ratio of death = 0.93, 95 % CI = 0.87–0.99), but the magnitude of this effect was attenuated among the cohort restricted to hormone receptor-positive tumors. In this population-based analysis, incidence rates of metastatic breast cancer at presentation increased slightly over time for both histologies, and particularly for lobular tumors. A modest improvement in metastatic breast cancer median overall survival was observed, but was apparently limited to ductal carcinomas.
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References
du Toit RS, Locker AP, Ellis IO, Elston CW, Nicholson RI, Robertson JF, Blamey RW (1991) An evaluation of differences in prognosis, recurrence patterns and receptor status between invasive lobular and other invasive carcinomas of the breast. Eur J Surg Oncol 17(3):251–257
Toikkanen S, Pylkkänen L, Joensuu H (1997) Invasive lobular carcinoma of the breast has better short- and long-term survival than invasive ductal carcinoma. Br J Cancer 76(9):1234–1240
Li CI, Anderson BO, Porter P, Holt SK, Daling JR, Moe RE (2000) Changing incidence rate of invasive lobular breast carcinoma among older women. Cancer 88(11):2561–2569
Li CI, Uribe DJ, Daling JR (2005) Clinical characteristics of different histologic types of breast cancer. Br J Cancer 93(9):1046–1052. doi:10.1038/sj.bjc.6602787
Li CI, Anderson BO, Daling JR, Moe RE (2003) Trends in incidence rates of invasive lobular and ductal breast carcinoma. JAMA 289(11):1421–1424
Li CI, Daling JR (2007) Changes in breast cancer incidence rates in the United States by histologic subtype and race/ethnicity, 1995 to 2004. Cancer Epidemiol Biomarkers Prev 16(12):2773–2780. doi:10.1158/1055-9965.EPI-07-0546
Ravdin PM, Cronin KA, Howlader N, Berg CD, Chlebowski RT, Feuer EJ, Edwards BK, Berry DA (2007) The decrease in breast-cancer incidence in 2003 in the United States. N Engl J Med 356(16):1670–1674. doi:10.1056/NEJMsr070105
Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J, Writing Group for the Women’s Health Initiative I (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA 288(3):321–333
Welch HG, Gorski DH, Albertsen PC (2015) Trends in metastatic breast and prostate cancer-lessons in cancer dynamics. N Engl J Med 373(18):1685–1687. doi:10.1056/NEJMp1510443
Bleyer A, Welch HG (2012) Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med 367(21):1998–2005. doi:10.1056/NEJMoa1206809
SEER cancer statistics review, 1975–2012. National Cancer Institute, Bethesda, MD (April 2015) http://seer.cancer.gov/archive/csr/1975_2012/ on November 2014 SEER data submission, posted to the SEER web site
Ly BH, Nguyen NP, Vinh-Hung V, Rapiti E, Vlastos G (2010) Loco-regional treatment in metastatic breast cancer patients: is there a survival benefit? Breast Cancer Res Treat 119(3):537–545. doi:10.1007/s10549-009-0610-z
Dawood S, Broglio K, Gonzalez-Angulo AM, Buzdar AU, Hortobagyi GN, Giordano SH (2008) Trends in survival over the past two decades among white and black patients with newly diagnosed stage IV breast cancer. J Clin Oncol 26(30):4891–4898. doi:10.1200/JCO.2007.14.1168
Andre F, Slimane K, Bachelot T, Dunant A, Namer M, Barrelier A, Kabbaj O, Spano JP, Marsiglia H, Rouzier R, Delaloge S, Spielmann M (2004) Breast cancer with synchronous metastases: trends in survival during a 14-year period. J Clin Oncol 22(16):3302–3308. doi:10.1200/JCO.2004.08.095
Surveillance, Epidemiology, and End Results, available at: http://seer.cancer.gov/data/seerstat/nov2011/. Accessed July 2015
Howlader N NA, Krapcho M, Neyman N, Aminou R, Waldron W, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA, Edwards BK SEER Cancer Statistics Review, 1975–2008, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2008/, based on November 2010 SEER data submission, posted to the SEER web site, 2011
Greene FL, American Joint Committee on Cancer, American Cancer Society. (2002) AJCC cancer staging handbook: from the AJCC cancer staging manual. 6th edn. Springer, New York
Statistical Methodology and Applications Branch SRP, National Cancer Institute: Joinpoint Regression Program, Version 4.2.0, April 2015
Sample Joinpoint Regression Analysis, available at: http://surveillance.cancer.gov/joinpoint/example.html. Accessed June 2015
Kim HJ, Fay MP, Feuer EJ, Midthune DN (2000) Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 19(3):335–351
Chia SK, Speers CH, D’yachkova Y, Kang A, Malfair-Taylor S, Barnett J, Coldman A, Gelmon KA, O’reilly SE, Olivotto IA (2007) The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer. Cancer 110(5):973–979. doi:10.1002/cncr.22867
Giordano SH, Buzdar AU, Smith TL, Kau SW, Yang Y, Hortobagyi GN (2004) Is breast cancer survival improving? Cancer 100(1):44–52. doi:10.1002/cncr.11859
Gennari A, Conte P, Rosso R, Orlandini C, Bruzzi P (2005) Survival of metastatic breast carcinoma patients over a 20-year period: a retrospective analysis based on individual patient data from six consecutive studies. Cancer 104(8):1742–1750. doi:10.1002/cncr.21359
Daling JR, Malone KE, Doody DR, Voigt LF, Bernstein L, Coates RJ, Marchbanks PA, Norman SA, Weiss LK, Ursin G, Berlin JA, Burkman RT, Deapen D, Folger SG, McDonald JA, Simon MS, Strom BL, Wingo PA, Spirtas R (2002) Relation of regimens of combined hormone replacement therapy to lobular, ductal, and other histologic types of breast carcinoma. Cancer 95(12):2455–2464. doi:10.1002/cncr.10984
Polednak AP (2015) Increase in distant stage breast cancer incidence rates in US women aged 25–49 Years, 2000–2011: the stage migration hypothesis. J Cancer Epidemiol 2015:710106. doi:10.1155/2015/710106
Ellis MJ, Llombart-Cussac A, Feltl D, Dewar JA, Jasiowka M, Hewson N, Rukazenkov Y, Robertson JF (2015) Fulvestrant 500 mg versus anastrozole 1 mg for the first-line treatment of advanced breast cancer: overall survival analysis from the phase II FIRST study. J Clin Oncol 33(32):3781–3787. doi:10.1200/JCO.2015.61.5831
Vaz-Luis I, Lin NU, Keating NL, Barry WT, Lii H, Winer EP, Freedman RA (2015) Racial differences in outcomes for patients with metastatic breast cancer by disease subtype. Breast Cancer Res Treat 151(3):697–707. doi:10.1007/s10549-015-3432-1
Colleoni M, Rotmensz N, Maisonneuve P, Mastropasqua MG, Luini A, Veronesi P, Intra M, Montagna E, Cancello G, Cardillo A, Mazza M, Perri G, Iorfida M, Pruneri G, Goldhirsch A, Viale G (2012) Outcome of special types of luminal breast cancer. Ann Oncol 23(6):1428–1436. doi:10.1093/annonc/mdr461
Yu J, Dabbs DJ, Shuai Y, Niemeier LA, Bhargava R (2011) Classical-type invasive lobular carcinoma with HER2 overexpression: clinical, histologic, and hormone receptor characteristics. Am J Clin Pathol 136(1):88–97. doi:10.1309/AJCP7URIW0QETTAT
Hoff ER, Tubbs RR, Myles JL, Procop GW (2002) HER2/neu amplification in breast cancer: stratification by tumor type and grade. Am J Clin Pathol 117(6):916–921. doi:10.1309/4NTU-N6K4-F8JF-EWRX
Altundag K, Ibrahim NK (2006) Aromatase inhibitors in breast cancer: an overview. Oncologist 11(6):553–562. doi:10.1634/theoncologist.11-6-553
Chang J, Clark GM, Allred DC, Mohsin S, Chamness G, Elledge RM (2003) Survival of patients with metastatic breast carcinoma: importance of prognostic markers of the primary tumor. Cancer 97(3):545–553. doi:10.1002/cncr.11083
Acknowledgments
This study used the Surveillance, Epidemiology, and End Results (SEER) database. The interpretation and reporting of these data are the sole responsibility of the authors. We thank Joyce Lii for her programming expertise, and the SEER*Stat Technical Support Team for their help with the incidence data used for the present study. The study was supported by Fundacao para a Ciencia e Tecnologia (HMSP-ICS/0004/2011, Career Development Award) (to Ines Vaz-Luis) and Dana–Farber Cancer Institute Friends Grant (to Ines Vaz-Luis).
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Rachel A. Freedman received institutional funding from Eisai, Genetech, and Puma Biotech. All the remaining authors have declared no conflict of interest.
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Di Meglio, A., Freedman, R.A., Lin, N.U. et al. Time trends in incidence rates and survival of newly diagnosed stage IV breast cancer by tumor histology: a population-based analysis. Breast Cancer Res Treat 157, 587–596 (2016). https://doi.org/10.1007/s10549-016-3845-5
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DOI: https://doi.org/10.1007/s10549-016-3845-5