title: Survival time according to the year of recurrence and subtype in recurrent breast cancer.
abstract: BACKGROUND
  Survival for patients with recurrent breast cancer has improved over time due to the introduction of modern systemic therapy. The aim of this study was to determine the impact of subtype and the year of recurrence on the survival times of recurrent breast cancer.
  
  
  METHODS
  Between 1979 and 2013, 813 patients who underwent initial treatment for primary breast cancer experienced recurrence. They were divided into two groups based on the year of recurrence; before 2000 and after 2001. Survival after recurrence was compared between these groups based on following criteria; subtypes, disease free interval (DFI), and dominant recurrent site. The median follow-up period after recurrence was 4.3 years.
  
  
  RESULTS
  Survival improved significantly in the after 2001 group, and a significant improvement in survival was only seen in the HER2-enriched subtype. Multivariate analysis revealed that DFI, ER, HER2 status, dominant recurrent site and the Ki-67 index value were significant prognostic factors. In the HER2-enriched subtype, the year of recurrence, DFI and dominant recurrent site were significant independent factors. In the other subtypes, these factors were not correlated with survival.
  
  
  CONCLUSIONS
  Our study revealed that the survival rate of patients with only the HER2-enriched subtype significantly improved after recurrence. To prolong the survival time after recurrence of both luminal and triple negative subtypes, the development of novel targeting therapies to overcome refractory recurrent breast cancer is extremely important.
authors.affiliation: Department of Breast and Endocrine Surgery, Kumamoto City Hospital, 1-1-60, Kotoh, Higashi-ku, Kumamoto 860-8505, Japan. Electronic address: mnakano1020@gmail.com.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakano
authors.affiliation: Department of Breast and Endocrine Surgery, Kumamoto City Hospital, 1-1-60, Kotoh, Higashi-ku, Kumamoto 860-8505, Japan.
authors.forename: Mamiko
authors.initials: M
authors.lastname: Fujisue
authors.affiliation: Department of Surgery, Kumamoto City Hospital, 1-1-60, Kotoh, Higashi-ku, Kumamoto 860-8505, Japan.
authors.forename: Rumiko
authors.initials: R
authors.lastname: Tashima
authors.affiliation: Department of Breast and Endocrine Surgery, Kumamoto City Hospital, 1-1-60, Kotoh, Higashi-ku, Kumamoto 860-8505, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okumura
authors.affiliation: Department of Breast and Endocrine Surgery, Kumamoto City Hospital, 1-1-60, Kotoh, Higashi-ku, Kumamoto 860-8505, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nishiyama
authors.affiliation: Department of Breast and Endocrine Surgery, Kumamoto City Hospital, 1-1-60, Kotoh, Higashi-ku, Kumamoto 860-8505, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Ohsako
authors.affiliation: Department of Pathology, Kumamoto City Hospital, 1-1-60, Kotoh, Higashi-ku, Kumamoto 860-8505, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Toyozumi
authors.affiliation: Department of Pathology, Kumamoto City Hospital, 1-1-60, Kotoh, Higashi-ku, Kumamoto 860-8505, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Arima
authors.affiliation: Department of Breast and Endocrine Surgery, Kumamoto City Hospital, 1-1-60, Kotoh, Higashi-ku, Kumamoto 860-8505, Japan.
authors.forename: Reiki
authors.initials: R
authors.lastname: Nishimura
mesh_terms: D000008:Abdominal Neoplasms / Q000401:mortality / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000737:chemistry* / Q000401:mortality* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D008940:Mitotic Index; D009364:Neoplasm Recurrence, Local / Q000737:chemistry / Q000401:mortality*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D011960:Receptors, Estrogen / Q000032:analysis; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000556:secondary; D015996:Survival Rate; D013997:Time Factors
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; C508053:ERBB2 protein, human
keywords: Breast cancer; Disease free interval; Metastatic disease; Subtype; Survival after recurrence