TY - JOUR
T1 - Metastatic behavior and overall survival according to breast cancer subtypes in stage IV inflammatory breast cancer
AU - Van Uden, D. J.P.
AU - Van Maaren, M. C.
AU - Strobbe, L. J.A.
AU - Bult, P.
AU - Van Der Hoeven, J. J.
AU - Siesling, S.
AU - De Wilt, J. H.W.
AU - Blanken-Peeters, C. F.J.M.
PY - 2019/10/17
Y1 - 2019/10/17
N2 - 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.
AB - 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.
KW - Breast cancer subtype
KW - Inflammatory breast cancer
KW - Metastases
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85073594992&partnerID=8YFLogxK
U2 - 10.1186/s13058-019-1201-5
DO - 10.1186/s13058-019-1201-5
M3 - Article
C2 - 31623649
AN - SCOPUS:85073594992
SN - 1465-5411
VL - 21
JO - Breast cancer research
JF - Breast cancer research
M1 - 113
ER -
