Abstract S2-03: Early follow up of a randomized trial evaluating resection of the primary breast tumor in women presenting with de novo stage IV breast cancer; Turkish study (protocol MF07-01)

2013 ◽  
Author(s):  
A Soran ◽  
V Ozmen ◽  
S Ozbas ◽  
H Karanlik ◽  
M Muslumanoglu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Randomized Trial ◽  
Study Protocol ◽  
Breast Tumor ◽  
De Novo ◽  
Stage Iv ◽  
Primary Breast Tumor ◽  
Stage Iv Breast Cancer

Impact of surgery and radiation of the primary among women with de novo stage IV breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1032-1032
Author(s):  
Shaheenah S. Dawood ◽  
Rebecca Alexandra Dent ◽  
Sudeep Gupta ◽  
Jennifer Keating Litton ◽  
Rashid Mustafa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
De Novo ◽  
Stage Iv ◽  
Primary Breast Tumor ◽  
Risk Of Death ◽  
Stage Iv Breast Cancer ◽  
Increased Risk ◽  
The Impact

1032 Background: The aim of this retrospective study was to determine the impact of surgery(S) and radiation(R) therapy to the primary tumor among patients (pts) with stage IV denovo breast cancer. Methods: The SEER registry was used to identify pts with denovo stageIV breast cancer diagnosed between 1988 and 2008. Pts were divided into 4 groups based on type of treatment to primary tumor: both S+R, S alone, R alone, or no treatment of primary (no S/R). Breast cancer specific survival (BCS) was calculated from the date of diagnosis of breast cancer to the date of death from breast cancer or last follow up. Survival outcomes were estimated by the Kaplan-Meier method, and Cox models were fit to determine the association between treatment of primary and survival after adjusting for potential confounders (e.g age, grade, hormone receptor and race). Results: 25903 pts were identified; 4640 (17.9%) S+R, 6556 (25.3%) S, 4467 (17.2%) R, and 10240 (39.5%) no S/R. 1183 (4.6%) had surgery to sites other than the primary. Median age was 63 years. Median follow-up was 14 months. Median BCS was 23 months. Median BCS among pts who underwent S+R, S, R and no S/R was 36 months, 31 months, 18 months and 15 months respectively (p<0.0001). Among pts who underwent S+R, median BCS among pts who did and did not have surgery to sites other than primary was 50 months and 41 months respectively (p=0.029). Of the pts treated with S+R 10-year BCS was 18%. In the multivariable model compared to women who were in the no S/R group those who underwent S (HR= 0.59, 95%CI 0.55- 0.62,p<0.0001) and S+R (HR=0.51, 95%CI 0.47-0.55,p<0.0001) had decreased risk of death from breast cancer and those who underwent R (HR=1.13, 95% CI 1.04-1.21, p=0.002) had an increased risk of death from breast cancer. Pts who had surgery to sites other than the primary tumor had decreased risk of death from breast cancer compared to those who did not (HR=0.80, 95%CI 0.72-0.89,p<0.0001). Conclusions: Our results indicate that S+R of the primary breast tumor among pts with denovo stage IV breast cancer maybe associated with a decreased risk of death from breast cancer. A select subgroup of pts who undergo S+R may also benefit from surgery to sites other than the primary which may afford them maximum survival advantage.

scholarly journals De novo Stage IV Luminal Breast Cancer: Yes or No for Local Treatment? Serial Cases and Review

2021 ◽  
Vol 9 (B) ◽  
pp. 1-5
Author(s):  
Marija Karakolevska-Ilova ◽  
Elena Simeonovska Joveva ◽  
Aleksandar Serafimov
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Bone Metastasis ◽  
Retrospective Studies ◽  
De Novo ◽  
Metastatic Breast ◽  
Stage Iv ◽  
Additional Surgery ◽  
Stage Iv Breast Cancer

BACKGROUND: Primary stage IV breast cancer accounts about of 3–5% of newly diagnosed breast cancer cases. The management of this patient subset mostly comprises systemic therapy, with additional surgery or radiotherapy to control locoregional symptoms. Some of the retrospective studies showed the benefit of locoregional treatment as the first treatment of choice for overall survival (OS), but the efficacy of primary site surgery remains controversial for OS in prospective, controlled trials. AIM: We aimed to presents series of cases with primary metastatic breast cancer with diffuse bone metastasis. MATERIALS AND METHODS: This study was serial of cases with primary metastatic breast cancer with diffuse bone metastasis and a review of the literature. All of the cases were treated with upfront surgical resection of the primary in the breast. RESULTS: During the follow-up period of 36 months, all of our patients were still alive. CONCLUSION: Retrospective studies about resection of primary tumor as the first treatment of choice are with conflicting results, which may be related to randomization bias, including different biological types of breast cancer, different metastatic sites, and patients with different menopausal status. On the other hand, prospective studies did not show any powerful results that would lead the treatment in de novo stage IV breast cancer because of few limitations such a short follow-up period (between 23 and 40 months), younger patients, ER-positive/HER2 negative tumors, and type of chemotherapy given or not upfront. The effect of upfront surgery in newly metastatic breast cancer patients is still challenging, so there is a need to identify the exact cohort of patients who could benefit from surgery.

Use of locoregional treatment to improve survival in de novo stage IV breast cancer patients with luminal-like and HER2-rich subtypes.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12003-e12003
Author(s):  
Pengyu Chen ◽  
Skye H Hong-Chun Cheng
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Breast Tumor ◽  
Triple Negative ◽  
Stage Iv ◽  
Hazard Ratio ◽  
Primary Breast Tumor ◽  
Her2 Overexpression ◽  
Locoregional Treatment ◽  
Stage Iv Breast Cancer

e12003 Background: Breast cancer has three major subtypes, including luminal-like (hormone receptor positive, no HER2 overexpression), HER2-rich (HER2 overexpression), and triple negative (hormone receptor negative and no HER2 overexpression). This study is to analyze the prognosis in each subtype of stage IV breast cancer patients. Methods: We reviewed 246 patients with de novo stage IV breast cancer treated at our hospital between 1990 and 2009. Multivariable Cox analysis was used to determine the survival associated the subtypes and clinicopathologic factors. Results: Patients with luminal-like subtype are mostly premonopausal (66.9%, P=0.0002), with abnormal CA 15-3 level at initial diagnosis (58.7%, P=0.01), with higher rate of bone mets (78.1%, P=0.02), and less rate of liver mets (23.1%, P<0.0001). Patients with HER2-rich and triple negative had higher rate of nuclear grade III of primary breast tumor, up to 35% and 40%, respectively (P=0.01). There is no difference in the systemic chemotherapy (82.2~95%, P=0.09) and locoregional treatment (40.0~51.2%, P=0.23) among three groups. The median overall survival of 246 patients was 23.1 months. The median overall survival in patients with luminal-like, HER2-rich, and triple negative subtype were 39.6, 17.9, and 13.3 months, respectively (P<0.0001). In multivariate analysis, hormone receptor and HER2 status were significant independent factors associated with survival (P<0.0001). Other significant factors associated with survival included liver mets (Hazard Ratio 2.3, P<0.0001), lung mets (Hazard Ratio 1.7, P=0.0004), and brain mets (Hazard Ratio 1.5, P=0.03). In subgroup analysis, locoregional treatment to primary breast tumor had significant survival benefit in patients with luminal-like (P=0.0001) and HER2-rich(P=0.0012) subtype. In triple negative subtype, local treatment did not improve outcome (P=0.9575). Conclusions: Hormone receptors and HER2 status are the most important factors affecting survival for these patients. Locoregional treatment to primary breast tumor may provide better outcome, especially those with luminal-like or HER2-rich subtype.

Trends in survival of stage IV breast cancer (BC) among Caucasian and African American (AA) BC patients (pts)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1000-1000
Author(s):  
S. S. Dawood ◽  
K. Broglio ◽  
G. Hortobagyi ◽  
S. Giordano
Keyword(s):  
Breast Cancer ◽  
De Novo ◽  
Stage Iv ◽  
Cox Models ◽  
Risk Of Death ◽  
Time Period ◽  
Stage Iv Breast Cancer ◽  
Interaction Term ◽  
Over Time

1000 Background: The aim of this review was to look at the trends in survival over time in patients(pts) with de novo stage IV BC and to identify factors that impact survival. Methods: We searched the SEER registry to identify pts with de novo stage IV breast cancer diagnosed between 1988 and 2003. Pts who were male, did not have microscopic confirmation of disease, had more than one primary, and who had a prior malignancy were excluded. Pts were divided into three groups based on their year of diagnosis separated into 5-year intervals: 1988 - 1993, 1994 - 1998, and 1999 -2003. Overall survival (OS) and BC specific survival (BCS) were calculated from the date of diagnosis to the date of death, last follow-up, or 12/31/03. Survival outcomes were estimated by the Kaplan-Meier method, and Cox models were fit to determine the characteristics that were independently associated with survival. Follow-up time was censored at 3 years for Cox analyses. Results: 15,438 pts were identified. 3796 pts were diagnosed from 1988–1993, 3954 from 1994–1998, and 7688 from 1999–2003. Median age was 62 years. Median follow-up was 16 months (mos) (range 0–191), 18 mos (range 0–199), and 11 mos (range 0–59) in periods 1988 - 1993, 1994 - 1998, and 1999 - 2003 respectively. Median OS was 18 mos overall and 16, 18, and 20 mos respectively for each time period. Median BCS was 23 mos overall and 20, 21, and 25 mos for each time period. In the multivariable model, more distant year of diagnosis, Grade 3 disease, higher number of positive LN, increasing age, being unmarried, ER- disease, PR- disease, and no surgery were all independently associated with worse BCS. The interaction term between ER and year of diagnosis was of borderline significance, indicating that over time, pts with ER+ disease had decreasing risk of death compared to patients with ER- disease (HR 0.98, 95% CI 0.96–1.00). An interaction term between race and year of diagnosis was significant, such that with each increasing year of diagnosis AA pts had increasing risk of death compared to whites (HR 1.04, 95% CI 1.01–1.07). Conclusions: The survival of de novo stage IV BC pts has modestly improved over time. Of concern, survival disparities between AA and white patients increased rather than diminished over time. No significant financial relationships to disclose.

scholarly journals Incorporation of biologic factors for the staging of de novo stage IV breast cancer

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Zhen-Yu He ◽  
Chen-Lu Lian ◽  
Jun Wang ◽  
Jian Lei ◽  
Li Hua ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Score ◽  
Distant Metastasis ◽  
De Novo ◽  
Stage Iv ◽  
Staging System ◽  
Sensitivity Analyses ◽  
Operating Characteristics ◽  
Prognostic Analysis ◽  
Stage Iv Breast Cancer

Abstract This study aimed to investigate the prognostic value of biological factors, including histological grade, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) status in de novo stage IV breast cancer. Based on eligibility, patient data deposited between 2010 and 2014 were collected from the surveillance, epidemiology, and end results database. The receiver operating characteristics curve, Kaplan–Meier analysis, and Cox proportional hazard analysis were used for analysis. We included 8725 patients with a median 3-year breast cancer-specific survival (BCSS) of 52.6%. Higher histologic grade, HER2-negative, ER-negative, and PR-negative disease were significantly associated with lower BCSS in the multivariate prognostic analysis. A risk score staging system separated patients into four risk groups. The risk score was assigned according to a point system: 1 point for grade 3, 1 point if hormone receptor-negative, and 1 point if HER2-negative. The 3-year BCSS was 76.3%, 64.5%, 48.5%, and 23.7% in patients with 0, 1, 2, and 3 points, respectively, with a median BCSS of 72, 52, 35, and 16 months, respectively (P < 0.001). The multivariate prognostic analysis showed that the risk score staging system was an independent prognostic factor associated with BCSS. Patients with a higher risk score had a lower BCSS. Sensitivity analyses replicated similar findings after stratification according to tumor stage, nodal stage, the sites of distant metastasis, and the number of distant metastasis. In conclusion, our risk score staging system shows promise for the prognostic stratification of de novo stage IV breast cancer.

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