title: Stage IV breast cancer: a population-based study about prognostic factors according to HER2 and HR status.
abstract: We aim to describe trends in net survival (NS) and to assess the prognostic factors among women with de novo metastatic breast cancer (MBC) according to human epidermal growth factor receptor 2 (HER2) and hormone receptor (HR) status. Data on women suffering from de novo MBC and diagnosed from 1998 to 2009 were provided by the Côte-d'Or breast cancer registry. NS was described using the Pohar Perme estimator and prognostic factors were investigated in a generalised linear model. We identified 232 patients (mean age = 64.7). Median NS was 29.2 months, 1- and 5-year NS were 76% and 26% respectively. The survival trend in patients with HER2-positive tumours who did not receive trastuzumab was similar to that in women with triple-negative tumours. A higher relative excess risk of death by cancer was observed for high-grade tumours [RER, relative excess rates = 1.76 (95% CI, confidence intervals: 1.17-2.62) for Scarff Bloom Richardson grade 3 vs. 1 + 2], while a lower risk was observed for luminal tumours [RER = 0.49 (95% CI: 0.27-0.89)] and HER2-positive tumours treated with trastuzumab [RER = 0.28 (95% CI: 0.14-0.59)], both compared with triple-negative tumours. Surgery of the primary tumour was associated with better survival [RER = 0.43 (95% CI: 0.28-0.68)]. With half of the women dead before 29 months, stage IV breast cancer still has a bleak outlook. Progress should continue with new target therapies for both HR and HER2 receptors.
authors.affiliation: Côte d'Or Breast Cancer Registry, CGFL, Dijon, France.|EA 4184 Centre d'Epidémiologie des populations, University of Burgundy, Dijon, France.
authors.forename: A
authors.initials: A
authors.lastname: Bertaut
authors.affiliation: Faculty of Medicine, Hemopathies Registry, Dijon, France.
authors.forename: M
authors.initials: M
authors.lastname: Mounier
authors.affiliation: Department of Medical Oncology, CGFL, Dijon, France.
authors.forename: I
authors.initials: I
authors.lastname: Desmoulins
authors.affiliation: Department of Medical Oncology, CGFL, Dijon, France.
authors.forename: S
authors.initials: S
authors.lastname: Guiu
authors.affiliation: Department of Pathology, CGFL, Dijon, France.
authors.forename: F
authors.initials: F
authors.lastname: Beltjens
authors.affiliation: Oncology and Radiotherapy Centre, Dijon, France.
authors.forename: A
authors.initials: A
authors.lastname: Darut-Jouve
authors.affiliation: Pathology Centre, Dijon, France.
authors.forename: T
authors.initials: T
authors.lastname: Ponnelle
authors.affiliation: Department of Pathology, CGFL, Dijon, France.
authors.forename: L
authors.initials: L
authors.lastname: Arnould
authors.affiliation: Côte d'Or Breast Cancer Registry, CGFL, Dijon, France.|EA 4184 Centre d'Epidémiologie des populations, University of Burgundy, Dijon, France.
authors.forename: P
authors.initials: P
authors.lastname: Arveux
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018275:Carcinoma, Lobular / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D000068878:Trastuzumab / Q000627:therapeutic use; D064726:Triple Negative Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: HER2 receptors; hormone receptors; metastatic breast cancer; net survival; population-based; register