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Survival with metastatic breast cancer based on initial presentation, de novo versus relapsed

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 16 January 2017

Abstract

Purpose

We hypothesized different Overall Survival (OS) in metastatic breast cancer (MBC) after relapse vs de novo presentation.

Methods

We identified women in British Columbia with MBC diagnosed between 01/2001 and 12/2009. OS from MBC was calculated for relapsed vs de novo cohorts in 3 subgroups, based on hormone receptors (HR) and HER2 status. Age at MBC, disease-free interval (DFI), de novo vs relapsed, year of MBC diagnosis, and systemic treatment were entered into univariable and multivariable analyses.

Results

We identified 3645 pts with known HR of which 2796 had known HER2. Median follow-up was 91 months. Median OS was longer for de novo vs relapsed MBC: HR+/HER2- 34 versus 23 months (mos) (p < 0.0001), HR−/HER2- (TN) 11 versus 8 mos (p = 0.02), HER2+ 29 versus 15 mos (p < 0.0001). For TN disease, no variable independently discriminated a group with increased risk of death. For both the HR +/HER2- and the HER2 + groups, relapsed vs de novo status (HzR 1.4 [95% CI 1.2–1.5; p < 0.0001], and HzR 1.6 [95% CI 1.4–1.9; p < 0.0001], respectively) and age >50 (HzR 1.2 [95% CI 1.1–1.4; p = 0.001] and HzR 1.3 [95% CI 1.1–1.5; p = 0.01], respectively) were associated with increased risk of death on multivariable analysis.

Conclusion

These data provide information that may guide discussions about prognosis between physicians and patients with MBC. In addition, it highlights the importance of stratifying for initial stage at diagnosis in future MBC therapeutic trials.

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Author contributions

WdB and CL had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. WdB, CS, EB, and CL were involved in extraction of the data. LG performed statistical analysis. All authors contributed to the writing of the manuscript and agreed to submit the article for publication.

Funding

No funding was received for this retrospective study.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, BC Cancer Agency, 600 West 10th Avenue, Vancouver, BC, V5Z 4E6, Canada

    Wendie D. den Brok, Caroline H. Speers, Lovedeep Gondara, Emily Baxter & Caroline A. Lohrisch

  2. Department of Radiation Oncology, BC Cancer Agency, Vancouver, BC, Canada

    Scott K. Tyldesley

Authors
  1. Wendie D. den Brok
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  2. Caroline H. Speers
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  3. Lovedeep Gondara
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  4. Emily Baxter
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  5. Scott K. Tyldesley
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  6. Caroline A. Lohrisch
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Corresponding author

Correspondence to Wendie D. den Brok.

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Conflict of interest

Authors WdB, CS, LG, EB and CL declare that they have no conflicts of interest. ST has acted in a consultant/advisory role for Amgen, the makers of Denosumab.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. Institutional research ethics board approval was obtained for this retrospective review of anonymized electronic records.

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den Brok, W.D., Speers, C.H., Gondara, L. et al. Survival with metastatic breast cancer based on initial presentation, de novo versus relapsed. Breast Cancer Res Treat 161, 549–556 (2017). https://doi.org/10.1007/s10549-016-4080-9

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  • DOI: https://doi.org/10.1007/s10549-016-4080-9

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