Clinical and nonclinical factors associated with confirmatory biopsy in metastatic breast cancer.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 249-249
Author(s):  
Jennifer J. Griggs ◽  
Thomas Braun ◽  
Dawn Marie Severson ◽  
Elizabeth Marie Layhe ◽  
David H. Gorski ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Multivariate Analyses ◽  
Metastatic Breast ◽  
Stage Iv ◽  
Primary Diagnosis ◽  
Clinical Factors ◽  
Obesity Status ◽  
Multiple Metastases ◽  
Stage Iv Disease

249 Background: In patients with metastatic breast cancer, clinical practice guidelines include obtaining histologic confirmation of metastases when possible. The purpose of this study was to investigate patterns and correlates of receipt of a confirmatory biopsy. Methods: Data were abstracted from the records of patients diagnosed with metastatic breast cancer in the Michigan Breast Oncology Quality Initiative (MiBOQI), a statewide registry of 25 health systems. Patients with Stage IV disease at diagnosis were excluded. Analyses investigated associations between receipt of a confirmatory biopsy and disease, clinical and non-clinical factors, and treating health system. Results: Data were available for 1,231 (96%) of eligible patients between 2006 and 2015. Of these, 66% had a confirmatory biopsy; the proportion of patients having a biopsy varied between the 25 sites from 41% to 100% (p = 0.03). In bivariate analyses, younger age (p = 0.02), lower comorbidity (p = 0.007), longer time between the primary and recurrence (p < 0.001), more recent year of recurrence (p = 0.01), having liver, skin, soft tissue, or multiple metastases (p < 0.001), and private or government insurance (p = 0.002) were associated with biopsy. In multivariate analyses, longer time since the primary diagnosis (p < 0.001), more recent year of recurrence (p = 0.03), initial site(s) of recurrence (p < 0.001), and private or government insurance (p = 0.004) remained significant predictors of biopsy. Treatment site was no longer significant (p = 0.14). Minority status, obesity status, and disease characteristics (stage, estrogen receptor, progesterone receptor, HER2, grade) of the primary were not significant in either bivariate or multivariate analyses. Analyses were repeated without insurance with no change in the other findings. Conclusions: In a statewide collaborative, the proportion of patients having a confirmatory biopsy increased over the study period and was associated with several clinical factors. Insurance was an independent and significant predictor of receipt of what is considered standard care.

Cancer disparities among patients with advanced metastatic breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18566-e18566
Author(s):  
Diana Saravia ◽  
Leah Elson ◽  
Hong Liang ◽  
Nadeem Bilani ◽  
Elizabeth Blessing Elimimian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Metastatic Breast Cancer ◽  
Hormonal Therapy ◽  
Triple Negative ◽  
Metastatic Breast ◽  
Stage Iv ◽  
Patient Characteristics ◽  
Receptor Status ◽  
Risk Of Death

e18566 Background: We previously elucidated sociodemographic factors associated with risk-of-death, in a subgroup of patients with Stage IV human epidermal growth factor 2 (HER)+ breast cancer. To further understand determinants of disparities in all subgroups of stage IV breast cancer, this study sought to evaluate factors which are predictive of overall survival (OS) in a cohort of patients with metastatic breast cancer (MBC), according to the following subtypes: 1) estrogen receptor (ER)+ or progesterone receptor (PR)+ and (HER)-, (2) (ER+ or PR+) and HER+, (3) (ER- and PR-) and HER-, or (4) (ER- and PR-) and HER+. Methods: Study population included patients with MBC, extracted from the National Cancer Database, treated between 2010 and 2016. Descriptive statistics were used to summarize patient characteristics, and chi-square tests were performed to compare patient characteristics, by ethnic group (white, black, Hispanic, Asian, and other). Multivariate Cox regression models with backward elimination (using significance level of p<0.05) were utilized to compare overall survival among patient cohorts. In addition, Kaplan-Meier survival curves of patient cohort were also produced. Statistics were performed using SAS. Results: Records from n= 47,032 patients were included, the majority were 50 years or older, white, and treated with hormonal therapy. With a median follow-up time of 2.3 years, disparities in OS were observed; black patients were more likely to suffer death (HR=1.12 (1.08-1.16), p<0.0001), compared to white patients. Additional factors contributing to risk of death in MBC included: being male (HR=1.12, (1.02-1.23), p=0.019), having visceral involvement compared to bone only (HR=1.52, (1.05-1.28), p<0.0001), income < $38,000 (HR=1.13 (1.09-1.17), p<0.0001), being on government insurance (HR=1.24, (1.20-1.27), p<0.0001, and having Triple Negative Breast Cancer (ER- and PR-) and HER- status (HR=1.68 (1.60-1.75) p<0.0001). Patients who receive chemotherapy, not hormonal therapy (HR=1.25 (1.2 – 1.3), p<0.0001), were found to have worse prognosis possibly reflecting biology of disease at presentation and lack of specific targeted therapy. Conclusions: This study confirms that sociodemographic disparities exist in OS among patients within the same stage of MBC, and regardless of receptor status subtypes. Clinical practice should focus on closing disparities gaps for those with advanced and MBC, especially among Black, impoverished, and male patients. Better treatment approaches should be sought for patients with visceral metastasis and those diagnosed with triple negative receptor status, who continue to suffer from worse outcomes.

Do the efficacy of BP-C1 correlate to receptor status in patients suffering from metastatic breast cancer stage IV?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12581-e12581
Author(s):  
Stig Einride Larsen ◽  
Kritiya Butthongkomvong ◽  
Sirikul Sorraritchingchai ◽  
Isaraporn Sangsaikae ◽  
Alexey Manikas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Stage Iv ◽  
Controlled Clinical Trial ◽  
Positive Group ◽  
Receptor Status ◽  
Lesion Diameter ◽  
Her 2 ◽  
Double Blinded

e12581 Background: Cis-coordinated complexes of platinum(II) with polymer of benzene polycarboxylic is currently evaluated in clinical trials for treatment of metastatic breast cancer (MBC) patients. The RECIST was used for evaluation of the target lesions and the sum diameter of the five largest target lesions was measured. BP-C1 inhibits tumor growth, improves quality of life with only few mild to moderate adverse events. The aim was to investigate the correlation between the efficacy of BP-C1 and the receptor status of Estrogen (ER), Progesterone (PR) and Human epidermal growth factor (HER-2) Methods: The material consists of prospectively collected results from 30 Thai and 30 Russian MBC patients included in two randomized and double-blinded controlled clinical trial with stratified semi-cross-over design. The patients received daily IM injections of 0.035mg/ml bw BP-C1 for 32 days. The results from Russia available by March 2017, and will be included in the final presentation Results: Negative ER recorded in 13 patients and positive in 15. During 32 days of BP-C1 treatment, the sum lesion diameters reduces with 1.9 % in the negative receptor group, but increases with 8.0 % among the positive. Similar pattern also detected regarding the PR. Negative PR detected in 17 patients and positive in 12. No changes (0.1%) in the sum lesion diameter found in the group with negative PR, but an increase of 8.8% in the positive group. Negative HER-2 receptor recorded in 13 patients and positive in 13. The sum lesion diameter increases with 7% in the negative group and 6.0% in the positive. In five patients, all the three receptors were positive, 10 patients had one negative receptor, 12 had two negative and three were triple negative. During the 32 days of BP-C1 treatment, the sum lesions increases by 20.7% in the triple positive group and by 7.6% in the group with one negative receptor. In the patients with two or three negative receptors, the sum lesion diameter was unchanged; -0.6% and 0.5%, respectively. The reduction sum lesion diameter seem to increase with increasing number of negative receptors. Conclusions: These findings indicate that BP-C1 may be an important treatment of stage IV MBC with negative ER, PR or HER-2 receptor.

Association of clinical factors and biological subtypes with different Ca15-3 levels in metastatic breast cancer.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e24014-e24014
Author(s):  
Marta Bonotto ◽  
Lorenzo Gerratana ◽  
Giacomo Pelizzari ◽  
Debora Basile ◽  
Marika Cinausero ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Clinical Factors
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