title: Diverse prognosis in metastatic breast cancer: who should be offered alternative initial therapies?
abstract: In an attempt to clarify appropriate treatment options for women with stage IV breast cancer, we studied the survival experience of a large dataset of patients treated on Cancer and Leukemia Group B (CALGB) protocols. The study, restricted to women who had had no prior chemotherapy for metastatic disease, demonstrated a surprisingly poor prognosis, with an estimated median survival of 1.6 years and only 26% alive at 3 years. Analysis of prognostic factors permitted the identification of subsets with even shorter survival, such as women with estrogen receptor negative tumor in more than one metastatic site and prior adjuvant chemotherapy. We feel that an evaluation of intensive investigational treatment approaches, such as trials using autologous bone marrow transplantation, is justified for most stage IV breast cancer patients, in view of their poor prognosis.
authors.affiliation: Division of Biostatistics, Dana-Farber Cancer Institute, Boston, MA.
authors.forename: R
authors.initials: R
authors.lastname: Mick
authors.forename: C B
authors.initials: CB
authors.lastname: Begg
authors.forename: K H
authors.initials: KH
authors.lastname: Antman
authors.forename: A H
authors.initials: AH
authors.lastname: Korzun
authors.forename: E
authors.initials: E
authors.lastname: Frei
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D002986:Clinical Trials as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D011960:Receptors, Estrogen