title: Comparison of the clinical and pathological features between patients with recurrent metastatic breast carcinoma and patients with initially metastatic breast carcinoma.
abstract: OBJECTIVE
  To compare initial metastatic breast carcinoma (MBC) with recurrent MBC and assess their biologic phenotypes and clinical behaviors.
  
  
  METHODS
  A comparison of clinical and biological characteristics and median overall survival times were assessed in the 251 patients with MBC at the Division of Medical Oncology, Ege University School of Medicine, and the Division of Radiation Oncology, Tepecik Government Hospital, Izmir, Turkey between 1995 and 2004. Hormone receptors, c-erbB-2, Ki-67, and p53 expressions were performed by immunohistochemistry.
  
  
  RESULTS
  Out of 251 MBC patients, 206 patients had recurrent MBC, and 45 had initial MBC. Regarding survival, there was no difference between the recurrent MBC group and the initial MBC group. The initial MBC group had a higher proportion of T4 tumors (46% versus 27%), a lower proportion of T1-2 tumors (31% versus 55%; p=0.01), and a higher percentage of patients with high Ki-67 expression (64% versus 49%; p=0.05). Multivariate analysis showed that T stage was an independent prognostic factor (p=0.02).
  
  
  CONCLUSIONS
  Patients with initial MBC tended to present with larger tumors. This relationship can be explained by delayed diagnosis. The potential for reducing death rates from breast cancer is contingent on educational improvement and increased screening rates.
authors.affiliation: Womens Health Nursing, Izmir Ataturk School of Health, Ege University, Bornova Izmir, Turkey. birsen.saydam@ege.edu.tr
authors.forename: Birsen K
authors.initials: BK
authors.lastname: Saydam
authors.forename: Gamze
authors.initials: G
authors.lastname: Goksel
authors.forename: Esra
authors.initials: E
authors.lastname: Korkmaz
authors.forename: Murat
authors.initials: M
authors.lastname: Kapkac
authors.forename: Necmettin
authors.initials: N
authors.lastname: Ozdemir
authors.forename: Canfeza
authors.initials: C
authors.lastname: Sezgin
authors.forename: Ruchan
authors.initials: R
authors.lastname: Uslu
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014421:Turkey / Q000453:epidemiology
chemical_list: D019394:Ki-67 Antigen