title: Survival of patients with de-novo metastatic breast cancer: analysis of data from a large breast cancer-specific private practice, a university-based cancer center and review of the literature.
abstract: Approximately 6 % of patients with breast cancer are diagnosed with de-novo distant metastases. We set out to look at two cohorts of patients seen at breast cancer-specific practices, compare the results to other reports and larger databases, and see how advances in treatment have impacted overall survival (OS). The records from a large breast cancer oncology private practice and a second data set from the University of Miami/Sylvester Comprehensive Cancer Center (UM/SCCC) tumor database were, retrospectively, reviewed to identify patients with de-novo metastases. We included those patients identified to have metastatic disease within 3 months of diagnosis of a breast primary cancer. Patients diagnosed between 1996 and 2006 were chosen for our study population. The OS for the private practice was 41.0 months (46.0 for ER positive and 26.0 for ER negative) and 36.0 months for UM/SCCC (52 months for ER positive and 36 months for ER negative). ER negativity and CNS- or visceral-dominant disease were associated with a significantly worse prognosis within the private practice. Dominant site was associated with a significantly worse prognosis within the UM/SCCC database but with a trend also for ER negativity. Age and ethnicity did not contribute significantly to the survival of patients within either cohort. The median survival in both cohorts and most other reported series was larger than that seen in the surveillance, epidemiology, and end results program and the National Cancer Database. The median OS among patients with de-novo metastatic breast cancer treated within two breast-specific oncology practices was over 3 years, which appears better than larger, more inclusive databases and publications from earlier decades.
authors.affiliation: Department of Hematology and Oncology at Winship Cancer Institute, Emory University, 1365 Clifton Road, Atlanta, GA, 30322, USA. simonzeichner@gmail.com.
authors.forename: Simon B
authors.initials: SB
authors.lastname: Zeichner
authors.affiliation: Tumor Registry, University of Miami Health System, Miami, FL, USA.
authors.forename: Stuart
authors.initials: S
authors.lastname: Herna
authors.affiliation: Department of Hematology and Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA.
authors.forename: Aruna
authors.initials: A
authors.lastname: Mani
authors.affiliation: Department of Hematology and Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
authors.forename: Tadeu
authors.initials: T
authors.lastname: Ambros
authors.affiliation: Department of Solid Tumor Oncology, Cleveland Clinic Foundation, Taussig Cancer Center, Cleveland, OH, USA.
authors.forename: Alberto J
authors.initials: AJ
authors.lastname: Montero
authors.affiliation: Department of Hematology and Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA.
authors.forename: Reshma L
authors.initials: RL
authors.lastname: Mahtani
authors.affiliation: Cancer Treatment Centers of America, Zion, IL, USA.
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Ahn
authors.affiliation: Department of Hematology and Oncology, University of Miami/Sylvester Comprehensive Cancer Center, Miami, FL, USA.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Vogel
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D002173:Cancer Care Facilities; D005260:Female; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011331:Private Practice; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor
keywords: De-novo metastatic breast cancer; ER; HER2; Survival