Patterns of distant metastasis in Chinese women according to breast cancer subtypes

Abstract

To access possible relationships between breast cancer subtypes (BCS) and patterns of distant metastasis in advanced breast cancer. Breast cancer patients with distant metastasis at two academic centers from 2000-2015 were retrospectively reviewed. The breast cancer was classified into four subtypes: hormone receptor (HR) +/ human epidermal growth factor receptor 2 (HER2) − (i.e., estrogen receptor [ER] + and/or progesterone receptor [PR] +, HER2−); HR+/HER2+ (ER+ and/or PR+, HER2+), HR−/HER2+ (ER− and PR−, and HER2+); and HR−/HER2− (ER− and PR−, and HER2−). A total of 679 patients were identified. The distribution of the BCS was 39.9% (271/679), 23.7% (161/679), 16.8% (114/679), and 19.6% (133/679) in HR+/HER2−, HR+/HER2+, HR−/HER2+, and HR−/HER2−, respectively. Patients with HR+/HER2+ and HR−/HER2+ subtypes were prone to abdominal and pelvic metastasis, those with HR+/HER2− and HR+/HER2+ subtypes were prone to bone metastasis, while patients with the HR−/HER2− subtype were prone to lung/mediastinal and brain metastases. In patients with pleural, axillary and/or neck lymph node, and other distant soft tissue metastases, there was no significant difference in metastatic patterns among the BCS. There are different patterns of distant metastasis associated with different BCS. There should be a different focus in the postoperative follow-up and monitoring of breast cancer patients with different BCS.

Clinical features of brain metastases in breast cancer: an implication for hippocampal-sparing whole-brain radiation therapy

“…We found that the patients with the HR−/HER2− subtype were more likely to develop BM in our previous study 24. In this study, significant differences in the number of BM were observed across the different BCSs.…”

Failure patterns according to molecular subtype in patients with invasive breast cancer following postoperative adjuvant radiotherapy: long-term outcomes in contemporary clinical practice

“…Importantly, this study revealed the subtype-based differential susceptibility to distant metastasis in the contemporary era of breast cancer treatment. Several previous reports have explored the subtype-related preferential sites of distant metastasis [16,[21][22][23][24][25][26]. However, their results were inconsistent.…”

“…and hormone receptor-negative/HER2(?) tumors were more prone to abdominal or pelvic metastasis, compared to patients with a hormone receptor-positive/HER2(-) tumor [adjusted odds ratio (aOR) 1.665, 95% CI 1.096-2.530; aOR 1.971, 95% CI 1.244-3.124, respectively] [26]. An early bioinformatics study found an association of Wnt signaling and focal adhesion factors with molecular subtypes and relapsed organs [27].…”

Racial/ethnic disparities in de novo metastases sites and survival outcomes for patients with primary breast, colorectal, and prostate cancer

“…For instance, in the absence of distant metastasis in colorectal cancer, surgery with curative intent is a common treatment modality, and adjuvant therapy is rarely essential if there is no evidence of lymphatic involvement . Past studies have examined patterns of metastasis and provide evidence that there are differences in the frequency, pattern, and site of distant metastasis for various primary tumors . In a comprehensive analysis of 16 major tumor sites, Budczies et al.…”

“…For instance, in the absence of distant metastasis in colorectal cancer, surgery with curative intent is a common treatment modality, and adjuvant therapy is rarely essential if there is no evidence of lymphatic involvement [10]. Past studies have examined patterns of metastasis and provide evidence that there are differences in the frequency, pattern, and site of distant metastasis for various primary tumors [8,[11][12][13][14]. In a comprehensive analysis of 16 major tumor sites, Budczies et al observed major differences in the frequency of metastasis across sites, with melanoma and breast cancers having the highest mean number of metastasis per case (5.9 and 5.2, respectively), and liver cancer with the lowest mean number of metastasis (2.3) [8].…”