TITLE:
Predictors for Metachronous Metastases in Early Breast Cancer: A Single Institution Study
AUTHORS:
Haytham Mahmoud Awad Fayed, Mohamed Ali Abdalla Billel, Galal Mostafa Abouelnagah, Gehan A. Khedr
KEYWORDS:
Breast Cancer, Metastasis, Relapse Free Survival, Overall Survival
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.10 No.3,
July
15,
2021
ABSTRACT: Background: Breast cancer (BC) is considered the most common women cancer worldwide. The main clinicopathological prognostic
factors are tumor size, lymph node status and estrogen/progesterone (ER/PR)
receptor status. In addition, some
factors are both prognostic and predictive as ER/PR receptors and HER2/neu
overexpression. Axillary lymph node status is the most important
prognostic factor for breast cancer. Node negative breast cancer patients had
the best 5-year overall survival (OS) of 82.8% compared to 73%, 45.7%, and
28.4% for patients with 1 - 3, 4 - 12, and
≥13 positive nodes, respectively. The aim of
this study was to determine the association between different
clinicopathological features and development of metastasis in a group of Egyptian women with early breast cancer, also, to assess patients’
Relapse-free survival (DFS) and OS and their correlation with different
clinicopathological features. Patients and Methods: We retrospectively
reviewed the files of breast cancer patients who were treated and followed-up at the clinical oncology department
and surgical oncology unit, Alexandria Main University Hospital during the
period from January 2014 to December 2017. A total of 1848 breast cancer cases
were presented during this period of time.
141 out of the 1848 patients developed metastasis from breast cancer during
follow-up. Among the 141 patients, only 102 had adequate clinical, pathological,
treatment and follow-up data enough for
analysis and were included in our study. Results: The number of patients
who developed distant metastasis from breast cancer during the study period
(metachronous metastasis) ranges from 17 - 31
cases/year. All the study patients had documented metastatic disease
constituting 102 out of 1848 collected patients representing about 5.5%. The
median time for development of metastasis
from the initial diagnosis among the 102 studied patients was 17.88 months.
Seventy-two out of 102 cases had distant recurrence. There was a significant correlation between DFS and
tumor size, grade, number of lymph nodes involved and hormone receptor (ER and PR) status. Age, tumor grade, tumor
size and Her2 status had a significant impact on the OS. Conclusion: The
clinicopathological characteristics of the primary tumor are important for
predicting the risk of metastasis among early breast cancer patients and
determining their prognosis.