Improved survival in metastatic breast cancer 1985-2016.
OBJECTIVE
In the last 25 years new treatment options in breast cancer have evolved. We wanted to determine whether the survival of; patients with metastatic breast cancer have improved during this period.


METHODS
Patients consecutively diagnosed with disseminated breast cancer 1985-2014 in the County of Kalmar, Sweden, were identified and followed to 2016. Survival was calculated for each successive 5 year interval. Separate analyses were performed for pts with ER and/or PR and HER2 positive tumours resp.


RESULTS
Median survival of the 784 patients increased successively from 13 to 33 months. Five year survival increased from 10 to 27%. Patients with high grade primary tumours had the shortest post recurrence survival time but their median survival increased significantly by time from 12 to 30 months, 3 year survival from 16 to 38% and 5 year from 5 to 20%. Median survival for patients with grade 2 tumours was 2 years and did not improve. Only 47 patients had grade 1 tumours and their median survival of 4 years did not change. Median survival for HER2 positive patients treated before the introduction of trastuzumab in year 2000 was 14 months and after 2000 29 months, 5 year survival improved from 2 to 31%.


CONCLUSIONS
Survival in metastatic breast cancer improved 1985-2016. For the first time a significant increase in survival time for patients with metastasis from fast-growing grade 3 tumours was seen. The most striking improvement was achieved in the HER2 positive subset.
Kalmar County Breast Centre, Surgery, County Hospital, Kalmar, Sweden. Electronic address: marie.sundqvist@ltkalmar.se.
Marie
M
Sundquist
Dep of Physiology, County Hospital, Kalmar, Sweden. Electronic address: lars.brudin@ltkalmar.se.
Lars
L
Brudin
Kalmar County Breast Centre, Surgery, Västervik Hospital, Sweden. Electronic address: goran@tejler.se.
Göran
G
Tejler
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016016:Proportional Hazards Models; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D012042:Registries; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D000068878:Trastuzumab / Q000627:therapeutic use
D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human
Breast cancer; Metastatic; Prognosis; Survival