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Metastatic relapse of stage I–III breast cancer in New Zealand

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Abstract

Purpose

This study aims to investigate the factors that influence the risk of metastatic relapse in women presenting with stage I-III breast cancer in New Zealand.

Methods

The study included women diagnosed with stage I–III breast cancer. Cumulative incidence of distant metastatic relapse was examined with the Kaplan–Meier method by cancer stage and subtype. Cox proportional hazards models were used to estimate the adjusted hazard ratio of developing recurrent metastatic breast cancer by cancer stage and biomarker subtype after adjustment for other factors.

Results

A total of 17,543 eligible women were identified. The 5-year cumulative incidence of metastatic recurrence was 3.7% for stage I, 13.3% for stage II and 30.9% for stage III disease. The adjusted hazard ratios (HR) of stage II and stage III breast cancer developing metastatic disease were 2.07 and 4.82 compared to stage I. The adjusted risk of distant metastatic relapse was highest for luminal B HER2- cancers (adjusted HR: 1.59 compared to luminal A disease). Higher grade cancers were associated with a higher risk of metastases. After adjustment, women aged 60–69 years and Asian women had the lowest risk of distant metastatic relapse.

Conclusions

The prognosis of women with locally invasive breast cancer differs greatly with the chance of developing metastatic disease depending on the stage of disease at diagnosis and the subtype. Grade of disease at diagnosis was also important. Māori or Pacific ethnicity did not influence the risk of developing metastatic disease, although Asian women seemed less likely to develop metastases.

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Acknowledgment

We would like to acknowledge the New Zealand Breast Cancer Foundation for the financial support and the Breast Cancer Foundation National Register for providing the detailed data.

Funding

This study was funded by New Zealand Breast Cancer Foundation.

Author information

Authors and Affiliations

  1. Medical Research Centre, The University of Waikato, Private Bag 3105, Hamilton, 3240, New Zealand

    Chunhuan Lao & Ross Lawrenson

  2. Medical Oncology, Waikato District Health Board, Hamilton, New Zealand

    Marion Kuper-Hommel

  3. School of Population Health, The University of Auckland, Auckland, New Zealand

    Mark Elwood

  4. School of Medicine, The University of Auckland, Auckland, New Zealand

    Ian Campbell

  5. General Surgery, Waikato District Health Board, Hamilton, New Zealand

    Ian Campbell

  6. Strategy and Funding, Waikato District Health Board, Hamilton, New Zealand

    Ross Lawrenson

Authors
  1. Chunhuan Lao
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  2. Marion Kuper-Hommel
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  3. Mark Elwood
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  4. Ian Campbell
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  5. Ross Lawrenson
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Contributions

All authors 1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; 2) drafted the work or revised it critically for important intellectual content; 3) approved the version to be published; and 4) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Chunhuan Lao.

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Conflict of interest

All authors declared no conflicts of interest.

Ethical approval

Ethics approval for the study was granted through the Northern A Health and Disability Ethics Committee, reference: 19/CEN/14/AM01.

Consent for publication

All authors have approved the publication of this study.

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Lao, C., Kuper-Hommel, M., Elwood, M. et al. Metastatic relapse of stage I–III breast cancer in New Zealand. Cancer Causes Control 32, 753–761 (2021). https://doi.org/10.1007/s10552-021-01426-0

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  • DOI: https://doi.org/10.1007/s10552-021-01426-0

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