title: Clinical characteristics and survival analysis of breast cancer molecular subtypes with hepatic metastases.
abstract: BACKGROUND
  The liver is one of the most common metastatic sites of breast cancer, hepatic metastases developing in 6%-25% of patients with breast cancer and being associated with a poor prognosis. The aim of this study was to analyze the survival and clinical characteristics of patients with hepatic metastases from breast cancer of different molecular subtypes and to investigate the prognostic and predictive factors that effect clinical outcome.
  
  
  METHODS
  We retrospectively studied the charts of 104 patients with breast cancer hepatic metastases diagnosed at Sun Yat-sen University Cancer Center from December 1990 to June 2009. Subtypes were defined as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) enriched, triple-negative (TN). Prognostic factor correlations with clinical features and treatment approaches were assessed at the diagnosis of hepatic metastases.
  
  
  RESULTS
  The median survival time was 16.0 months, and the one-, two- three-, four-, five- year survival rates were 63.5%, 31.7%, 15.6%, 10.8%, and 5.4%, respectively. Median survival periods after hepatic metastases were 19.3 months (luminal A), 13.3 months (luminal B), 18.9 months (HER2-enriched), and 16.1 months (TN, P=0.11). In multivariate analysis, a 2 year-interval from initial diagnosis to hepatic metastasis, treatment with endocrine therapy, and surgery were independent prognostic factors. Endocrine therapy could improve the survival of luminal subtypes (P=0.004) and was a favorable prognostic factor (median survival 23.4 months vs. 13.8 months, respectively, P=0.011). Luminal A group of patients treated with endocrine therapy did significantly better than the Luminal A group of patients treated without endocrine therapy (median survival of 48.9 vs. 13.8 months, P=0.003).
  
  
  CONCLUSIONS
  Breast cancer subtypes were not associated with survival after hepatic metastases. Endocrine therapy was a significantly favorable treatment for patients with luminal subtype.
authors.affiliation: Department of Breast Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Qi-Dong
authors.initials: QD
authors.lastname: Ge
authors.forename: Ning
authors.initials: N
authors.lastname: Lv
authors.forename: Ya-Nan
authors.initials: YN
authors.lastname: Kong
authors.forename: Xin-Hua
authors.initials: XH
authors.lastname: Xie
authors.forename: Ni
authors.initials: N
authors.lastname: He
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Xie
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000145:classification / Q000401:mortality* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000145:classification / Q000401:mortality* / Q000556:secondary; D018275:Carcinoma, Lobular / Q000145:classification / Q000401:mortality* / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000145:classification / Q000401:mortality* / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone