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

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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

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Inflammatory Breast Neoplasms
Hormones
Breast Neoplasms
Survival
Neoplasm Metastasis
human ERBB2 protein
Bone and Bones
Neoplasms
Liver Neoplasms

Keywords

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

Cite this

Van Uden, D. J.P. ; Van Maaren, M. C. ; Strobbe, L. J.A. ; Bult, P. ; Van Der Hoeven, J. J. ; Siesling, S. ; De Wilt, J. H.W. ; Blanken-Peeters, C. F.J.M. / Metastatic behavior and overall survival according to breast cancer subtypes in stage IV inflammatory breast cancer. In: Breast cancer research. 2019 ; Vol. 21.
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title = "Metastatic behavior and overall survival according to breast cancer subtypes in stage IV inflammatory breast cancer",
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.",
keywords = "Breast cancer subtype, Inflammatory breast cancer, Metastases, Survival",
author = "{Van Uden}, {D. J.P.} and {Van Maaren}, {M. C.} and Strobbe, {L. J.A.} and P. Bult and {Van Der Hoeven}, {J. J.} and S. Siesling and {De Wilt}, {J. H.W.} and Blanken-Peeters, {C. F.J.M.}",
year = "2019",
month = "10",
day = "17",
doi = "10.1186/s13058-019-1201-5",
language = "English",
volume = "21",
journal = "Breast cancer research",
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Metastatic behavior and overall survival according to breast cancer subtypes in stage IV inflammatory breast cancer. / Van Uden, D. J.P.; Van Maaren, M. C.; Strobbe, L. J.A.; Bult, P.; Van Der Hoeven, J. J.; Siesling, S.; De Wilt, J. H.W.; Blanken-Peeters, C. F.J.M.

In: Breast cancer research, Vol. 21, 113, 17.10.2019.

Research output: Contribution to journalArticleAcademicpeer-review

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

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U2 - 10.1186/s13058-019-1201-5

DO - 10.1186/s13058-019-1201-5

M3 - Article

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AN - SCOPUS:85073594992

VL - 21

JO - Breast cancer research

JF - Breast cancer research

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