Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study
Weikai Xiao,1,* Shaoquan Zheng,1,* Anli Yang,2,* Xingcai Zhang,3,* Yutian Zou,1 Hailin Tang,1 Xiaoming Xie1 1Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Pe...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2018-11-01
|
| Series: | Cancer Management and Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/breast-cancer-subtypes-and-the-risk-of-distant-metastasis-at-initial-d-peer-reviewed-article-CMAR |
| _version_ | 1818290148710809600 |
|---|---|
| author | Xiao W Zheng S Yang A Zhang X Zou Y Tang H Xie X |
| author_facet | Xiao W Zheng S Yang A Zhang X Zou Y Tang H Xie X |
| author_sort | Xiao W |
| collection | DOAJ |
| description | Weikai Xiao,1,* Shaoquan Zheng,1,* Anli Yang,2,* Xingcai Zhang,3,* Yutian Zou,1 Hailin Tang,1 Xiaoming Xie1 1Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, People’s Republic of China; 2Department of Medicine; Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; 3Department of Applied Physics, Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA 02138, USA *These authors contributed equally to this work Background: It was unclear whether breast cancer subtypes are associated with the risk of site-specific metastases. This study aimed to evaluate the relationship between molecular subtypes and distant metastatic sites and their prognostic significance. Methods: We identified 295,213 patients with invasive breast cancer from 2010 to 2014 using the Surveillance, Epidemiology and End Results database. Subtypes were classified into four categories: hormone receptor (HR+)/human epidermal growth factor receptor 2 (HER2−), HR+/HER2+, HR−/HER2+, and triple-negative (HR−/HER2−). Logistic regression was used to assess the association between metastasis location and subtypes. Multivariate Cox models were used to estimate the overall survival (OS) of related factors. Results: According to our study, 3.28%, 1.52%, 1.20%, and 0.35% of newly diagnosed breast cancers presented bone, lung, liver, and brain metastases at diagnosis, respectively. Both metastatic sites and subtypes significantly affected the OS after metastasis. In multivariate analysis, HR+/HER2+ subtype (OR as compared with HR+/HER2− subtype, 1.30 [95% CI, 1.22–1.39]) significantly correlated with elevated bone metastasis risk, whereas HR−/HER2+ did not. Both HER2+ subtypes (HR+/HER2+ and HR−/HER2+) were significantly associated with higher rates of liver, brain, and lung metastases, while the highest OR was observed in liver metastases. Triple-negative tumors had a higher rate of brain (OR, 1.95 [95% CI, 1.61–2.35]), liver (OR, 1.35 [95% CI, 1.20–1.51]), and lung metastases (OR, 1.34 [95% CI, 1.21–1.47]), but a significantly lower rate of bone metastases (OR, 0.64 [95% CI, 0.59–0.69]) than HR+/HER2− tumors. Conclusions: Breast cancer subtypes are associated with different metastatic patterns and confer different prognostic impacts. Molecular subtypes can identify patients at increased risk of site-specific metastases. Keywords: breast cancer, molecular subtypes, metastasis behavior, prognosis, metastatic sites |
| first_indexed | 2024-12-13T02:23:34Z |
| format | Article |
| id | doaj.art-fb004c1ed2cc4b9da0e45a8d6ec63cd9 |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-13T02:23:34Z |
| publishDate | 2018-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-fb004c1ed2cc4b9da0e45a8d6ec63cd92022-12-22T00:02:43ZengDove Medical PressCancer Management and Research1179-13222018-11-01Volume 105329533842031Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based studyXiao WZheng SYang AZhang XZou YTang HXie XWeikai Xiao,1,* Shaoquan Zheng,1,* Anli Yang,2,* Xingcai Zhang,3,* Yutian Zou,1 Hailin Tang,1 Xiaoming Xie1 1Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, People’s Republic of China; 2Department of Medicine; Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; 3Department of Applied Physics, Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA 02138, USA *These authors contributed equally to this work Background: It was unclear whether breast cancer subtypes are associated with the risk of site-specific metastases. This study aimed to evaluate the relationship between molecular subtypes and distant metastatic sites and their prognostic significance. Methods: We identified 295,213 patients with invasive breast cancer from 2010 to 2014 using the Surveillance, Epidemiology and End Results database. Subtypes were classified into four categories: hormone receptor (HR+)/human epidermal growth factor receptor 2 (HER2−), HR+/HER2+, HR−/HER2+, and triple-negative (HR−/HER2−). Logistic regression was used to assess the association between metastasis location and subtypes. Multivariate Cox models were used to estimate the overall survival (OS) of related factors. Results: According to our study, 3.28%, 1.52%, 1.20%, and 0.35% of newly diagnosed breast cancers presented bone, lung, liver, and brain metastases at diagnosis, respectively. Both metastatic sites and subtypes significantly affected the OS after metastasis. In multivariate analysis, HR+/HER2+ subtype (OR as compared with HR+/HER2− subtype, 1.30 [95% CI, 1.22–1.39]) significantly correlated with elevated bone metastasis risk, whereas HR−/HER2+ did not. Both HER2+ subtypes (HR+/HER2+ and HR−/HER2+) were significantly associated with higher rates of liver, brain, and lung metastases, while the highest OR was observed in liver metastases. Triple-negative tumors had a higher rate of brain (OR, 1.95 [95% CI, 1.61–2.35]), liver (OR, 1.35 [95% CI, 1.20–1.51]), and lung metastases (OR, 1.34 [95% CI, 1.21–1.47]), but a significantly lower rate of bone metastases (OR, 0.64 [95% CI, 0.59–0.69]) than HR+/HER2− tumors. Conclusions: Breast cancer subtypes are associated with different metastatic patterns and confer different prognostic impacts. Molecular subtypes can identify patients at increased risk of site-specific metastases. Keywords: breast cancer, molecular subtypes, metastasis behavior, prognosis, metastatic siteshttps://www.dovepress.com/breast-cancer-subtypes-and-the-risk-of-distant-metastasis-at-initial-d-peer-reviewed-article-CMARMolecular subtypesbreast cancerdistant metastasisprognosismetastatic sites |
| spellingShingle | Xiao W Zheng S Yang A Zhang X Zou Y Tang H Xie X Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study Cancer Management and Research Molecular subtypes breast cancer distant metastasis prognosis metastatic sites |
| title | Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study |
| title_full | Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study |
| title_fullStr | Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study |
| title_full_unstemmed | Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study |
| title_short | Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study |
| title_sort | breast cancer subtypes and the risk of distant metastasis at initial diagnosis a population based study |
| topic | Molecular subtypes breast cancer distant metastasis prognosis metastatic sites |
| url | https://www.dovepress.com/breast-cancer-subtypes-and-the-risk-of-distant-metastasis-at-initial-d-peer-reviewed-article-CMAR |
| work_keys_str_mv | AT xiaow breastcancersubtypesandtheriskofdistantmetastasisatinitialdiagnosisapopulationbasedstudy AT zhengs breastcancersubtypesandtheriskofdistantmetastasisatinitialdiagnosisapopulationbasedstudy AT yanga breastcancersubtypesandtheriskofdistantmetastasisatinitialdiagnosisapopulationbasedstudy AT zhangx breastcancersubtypesandtheriskofdistantmetastasisatinitialdiagnosisapopulationbasedstudy AT zouy breastcancersubtypesandtheriskofdistantmetastasisatinitialdiagnosisapopulationbasedstudy AT tangh breastcancersubtypesandtheriskofdistantmetastasisatinitialdiagnosisapopulationbasedstudy AT xiex breastcancersubtypesandtheriskofdistantmetastasisatinitialdiagnosisapopulationbasedstudy |