Metastatic behavior and overall survival according to breast cancer subtypes in stage IV inflammatory breast cancer

D. J.P. Van Uden*, M. C. Van Maaren, L. J.A. Strobbe, P. Bult, J. J. Van Der Hoeven, S. Siesling, J. H.W. De Wilt, C. F.J.M. Blanken-Peeters

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)
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Abstract

Background: Distant metastatic disease is frequently observed in inflammatory breast cancer (IBC), with a poor prognosis as a consequence. The aim of this study was to analyze the association of hormone receptor (HR) and human epidermal growth factor receptor-2 (HER2) based breast cancer subtypes in stage IV inflammatory breast cancer (IBC) with preferential site of distant metastases and overall survival (OS). Methods: For patients with stage IV IBC, diagnosed in the Netherlands between 2005 and 2016, tumors were classified into four breast cancer subtypes: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. Patient, tumor, and treatment characteristics and sites of metastases were compared. OS of the subtypes was compared using Kaplan-Meier curves and the log-rank test. Association between subtype and OS was assessed in multivariable models using logistic regression. Results: In total, 744 eligible patients were included: 340 (45.7%) tumors were HR+/HER2-, 148 (19.9%) HR-/HER2+, 131 (17.6%) HR+/HER2+, and 125 (16.8%) HR-/HER2-. Bone was the most common metastatic site in all subtypes. A significant predominance of bone metastases was found in HR+/HER2-IBC (71.5%), and liver and lung metastases in the HR-/HER2+ (41.2%) and HR-/HER2-(40.8%) subtypes, respectively. In multivariable analysis, the HR-/HER2-subtype was associated with significantly worse OS as compared to the other subtypes. Conclusion: Breast cancer subtypes in stage IV IBC are associated with distinct patterns of metastatic spread and display notable differences in OS. The use of breast cancer subtypes can guide a more patient-tailored staging directed to metastatic site and extend of disease.

Original languageEnglish
Article number113
JournalBreast cancer research
Volume21
DOIs
Publication statusPublished - 17 Oct 2019

Keywords

  • Breast cancer subtype
  • Inflammatory breast cancer
  • Metastases
  • Survival

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