New insights into the metastatic behavior after breast cancer surgery, according to well-established clinicopathological variables and molecular subtypes.

Détails

ID Serval
serval:BIB_D0C2F825AA5D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
New insights into the metastatic behavior after breast cancer surgery, according to well-established clinicopathological variables and molecular subtypes.
Périodique
PloS one
Auteur⸱e⸱s
Buonomo O.C., Caredda E., Portarena I., Vanni G., Orlandi A., Bagni C., Petrella G., Palombi L., Orsaria P.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Statut éditorial
Publié
Date de publication
2017
Peer-reviewed
Oui
Volume
12
Numéro
9
Pages
e0184680
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Despite advances in treatment, up to 30% of patients with early breast cancer (BC) experience distant disease relapse. However, a comprehensive understanding of tumor spread and site-specific recurrence patterns remains lacking. This retrospective case-control study included 103 consecutive patients with metastatic BC admitted to our institution (2000-2013). Cases were matched according to age, tumor biology, and clinicopathological features to 221 patients with non-metastatic BC (control group). The median follow-up period among the 324 eligible patients was 7.3 years. While relatively low values for sensitivity (71%) and specificity (56%) were found for axillary lymph node (ALN) involvement as an indicator of risk and pattern of distant relapse, nodal status remained the most powerful predictor of metastases (OR: 3.294; CL: 1.9-5.5). Rates of dissemination and metastatic efficiency differed according to molecular subtype. HER2-positive subtypes showed a stronger association with systemic spread (OR: 2.127; CL: 1.2-3.8) than other subgroups. Classification as Luminal or Non-Luminal showed an increased risk of lung and distant nodal recurrence, and a decreased risk in bone metastases in the Non-Luminal group (OR: 2.9, 3.345, and 0.2, respectively). Tumors with HER2 overexpression had a significantly high risk for distant relapse (OR: 2.127) compared with HER2-negative tumors and also showed higher central nervous system (CNS) and lung metastatic potential (OR: 5.6 and 2.65, respectively) and low risk of bone disease progression (OR: 0.294). Furthermore, we found significant associations between biological profiles and sites of recurrence. A new process of clinical/diagnostic staging, including molecular subtypes, could better predict the likelihood of distant relapses and their anatomical location. Recognition and appreciation of clinically distinct molecular subtypes may assist in evaluation of the probability of distant relapses and their sites. Our analysis provides new insights into management of metastatic disease behavior, to lead to an optimal disease-tailored approach and appropriate follow-up.

Mots-clé
Adult, Aged, Aged, 80 and over, Bone Neoplasms/metabolism, Bone Neoplasms/pathology, Bone Neoplasms/secondary, Breast Neoplasms/metabolism, Breast Neoplasms/pathology, Breast Neoplasms/surgery, Female, Follow-Up Studies, Humans, Lung Neoplasms/metabolism, Lung Neoplasms/pathology, Lung Neoplasms/secondary, Middle Aged, Neoplasm Metastasis, Receptor, ErbB-2/metabolism, Recurrence, Retrospective Studies, Risk Factors, Time Factors
Pubmed
Web of science
Open Access
Oui
Création de la notice
22/11/2017 11:13
Dernière modification de la notice
20/08/2019 15:51
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