title: Identifying the potential long-term survivors among breast cancer patients with distant metastasis.
abstract: We aimed to develop a prediction model to identify long-term survivors after developing distant metastasis from breast cancer.
  
  
  
  From the institution's database, we collected data of 547 patients who developed distant metastasis during their follow-ups. We developed a model that predicts the post-metastasis overall survival (PMOS) based on the clinicopathologic factors of the primary tumors and the characteristics of the distant metastasis. For validation, the survival data of 254 patients from four independent institutions were used.
  
  
  
  The median duration of the PMOS was 31.0 months. The characteristics of the initial primary tumor, such as tumor stage, hormone receptor status, and Ki-67 expression level, and the characteristics of the distant metastasis presentation including the duration of disease-free interval, the site of metastasis, and the presence of metastasis-related symptoms were independent prognostic factors determining the PMOS. The association between tumor stage and the PMOS was only seen in tumors with early relapses. The PMOS score, which was developed based on the above six factors, successfully identified patients with superior survival after metastasis. The median PMOS for patients with a PMOS score of <2 and for patients with a PMOS score of >5 were 71.0 and 12 months, respectively. The clinical significance of the PMOS score was further validated using independent multicenter datasets.
  
  
  
  We have developed a novel prediction model that can classify breast cancer patients with distant metastasis according to their survival after metastasis. Our model can be a valuable tool to identify long-term survivors who can be potential candidates for more intensive multidisciplinary approaches. Furthermore, our model can provide a more reliable survival information for both physicians and patients during their informed decision-making process.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul.
authors.forename: E S
authors.initials: ES
authors.lastname: Lee
authors.affiliation: Center for Breast Cancer, National Cancer Center, Goyang.
authors.forename: S Y
authors.initials: SY
authors.lastname: Jung
authors.affiliation: Department of Surgery, College of Medicine, Gyeongsang National University, Jinju.
authors.forename: J Y
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul.
authors.forename: J J
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul.
authors.forename: T K
authors.initials: TK
authors.lastname: Yoo
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul.
authors.forename: Y G
authors.initials: YG
authors.lastname: Kim
authors.affiliation: Center for Breast Cancer, National Cancer Center, Goyang.
authors.forename: K S
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Center for Breast Cancer, National Cancer Center, Goyang.
authors.forename: E S
authors.initials: ES
authors.lastname: Lee
authors.affiliation: Department of Surgery, Breast Cancer Center, Seoul National University Bundang Hospital, Seongnam.
authors.forename: E K
authors.initials: EK
authors.lastname: Kim
authors.affiliation: Department of Surgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Min
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul.
authors.forename: W
authors.initials: W
authors.lastname: Han
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul.
authors.forename: D Y
authors.initials: DY
authors.lastname: Noh
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul moonhg74@snu.ac.kr.
authors.forename: H G
authors.initials: HG
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D000073116:Cancer Survivors; D018572:Disease-Free Survival; D047628:Estrogen Receptor alpha / Q000235:genetics; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000235:genetics; D008207:Lymphatic Metastasis / Q000235:genetics / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011980:Receptors, Progesterone / Q000235:genetics
chemical_list: C506487:ESR1 protein, human; D047628:Estrogen Receptor alpha; D019394:Ki-67 Antigen; D011980:Receptors, Progesterone
keywords: breast cancer; prediction model; stage IV; survival after metastasis