Comparison of Metastatic and Non-Metastatic Breast Cancer Patients according to TNM, Hormone Status and Her-2 Condition

Document Type : Original Article

Authors

1 Associate Professor , Department of Radiation Oncology, Solid Tumor Treatment Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Assistant Professor , Department of Radiation Oncology, Solid Tumor Treatment Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 M.Sc. of Statistics, Solid Tumor Treatment Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Breast cancer is the most common cause of death among Iranian women. A significant number of breast cancer patients are involved metastasis that is an important factor in treatment failure, morbidity and mortality of patients. The aim of present study was comparison of metastatic and non-metastatic breast cancer patients.
Methods: In this analytical descriptive study, 1615 files of patients with breast cancer who referred to Omid hospital in Mashhad, Iran during 2001 to 2011 were evaluated. 446 patients of them were in metastatic status. Checklists were completed according to each patient's data. Data were analyzed using SPSS software (version 16), and chi-square test and t-tests. P value less than 0.05 was considered significant.
Results: In 446 patients with metastatic breast cancer, 100 patients (22.4%) had metastasis in the first admission and in 346 patients (77.6%) metastases developed during the treatment or follow up. The most common sites for metastasis were bone (45.1%) and liver (20%). Immunohistochemical findings revealed that most of patients with brain and liver metastasis were Her-2 positive whereas the majority of patients with bone metastasis were Her-2 negative. There were no significant relationships between the two groups in terms of menstrual status, location of metastasis, positive rates of estrogen and progesterone receptors and Her-2.
Conclusion: The most common site of metastasis is bone (more patients with negative Her-2 and positive hormone receptors) while the common sites for metastasis as far as Her-2 positive is concerned are brain and liver with worse prognosis, concerning special attention for aggressive treatment.

Keywords

References

  1. Burstein HJ, Harris JR, Morrow M. Malignant tumors of the breast. In: DeVita VT, Laerence TS, Rosenberg SA. DeVita, Hellman, and Rosenberg's cancer: principles & practice of oncology. 9th Philadelphia:Lippincott Williams & Wilkins;2011:1401-45.
  2. Cristofanilli M, Gonzalez-Angulo AM, Buzdar AU, Kau SW, Frye DK, Hortobagyi GN. Paclitaxel improves the prognosis in estrogen receptor negative inflammatory breast cancer: the M. D. Anderson Cancer Center experience. Clin Breast Cancer 2004 Feb;4(6):415-9.
  3. Cho HS, Mason K, Ramyor KX, Stanly AM, Gabell SB, Denney DW, et al. Structure of the extracellular region of HER2 alone and in complex with Herceptin Fab. Nature 2003 Feb 13;421(6924):756-60.
  4. Wilton CJ, Reeve JR, Going JJ, Cooke TG, Bartlett JM. Expression of the HER1-4 family of receptor tyrosine kinase in breast cancer. J Pathol 2003 Jul;200(3):290-7.
  5. Joenson H, Isola J, Lundin M, Salminen T, Holli K, Kataja V. Amplification of erb-b2 and erb-b2 expression are superior to ER status as risk factor for distance recurrence in patient T1N0M0 breast cancer. Clin Cancer Res 2003;9(3):223-309.
  6. Wang-Rodriguez J, Cross K, Callagher S, Djahanban M, Armstrong JM, Wiedner N, et al. Male breast cancer correlation of ER, PR, Ki-67, Her2 Neu, and p53 with treatment and survival, a study of 65 cases. Mod Pathol 2002 Aug;15(8):853-61.
  7.  
 
   

  • Lipton A, Ali SM, Leitzel K, Demers L, Chinchilli V, Engle L, et al. Eleuated serum Her-2/neu level predicts decrease response to hormone thrapy in metatatic breast cancer. J Clin Oncol 2002 Mar 15;20(6):1467-72.
  1. Wuy Kan H, Chilar R, Vadgama. Prognostic value of plasma HER-2/neu in African American and Hispanic woman with breast cancer. Int J Oncol 1999 Jun;14(6):1021-37.
  2. Key TJ, Verkasalo PK, Banks E. Epidemiology of breast cancer. Lancet Oncol 2001 Mar;2(3):133-.04
  3. Harirchi I, Karbakhsh M, Kashefi A, Momtahen AJ. Breast cancer in Iran: results of a multi-center study. Asian Pac J Cancer Prev 2004 Jan-Mar;5(1):24-7.
  4. Ensani F, Hadad P, Hajsadegi N. [Evaluation of predictive and prognostic factors and their effects on survival rate in a group patients with breast carcinoma] [Article in Persian]. Iran J Surg 2005;13(2):69-76.
  5. Sirati F, Yadegari K. [Determination of the correlation between Her-2 tumor factor and invasion of breast cancer     to axillary lymph nodes in patients undergoing mastectomy in Cancer Institute, 2001-2003]. [Article in Persian]. Razi J Med Sci2004;11(43):781-7.
  6. Winer EP, Morrow M, Osborne CK, Harris JR. Malignant tumors of the breast. In: Devita VT, Hellman S, Rosenberg SA. Cancer principles and practice of oncology. 6th Philadelphia:Lippincott Williams & Wilkins;2001:1651-99.
  7. Wood WC, Muss HB, Solin LJ, Olopade OI. Malignant tumors of the breast. In: Devita VT, Hellman S, Rosenberg SA. Cancer principles and practice of oncology. 7th Philadelphia: Lippincott Williams & Wilkins;2005:1415-.07
  8. Blank KI, Beenkem SW, Copeland EM. The Breast. In: Brunicardi FC, Schwartz SI. Principles of surgery. 8th New York:McGraw- Hill;2005:453-.105
  9. Gao D, Du J, Cong L, Liu Q. Risk factors for initial lung metastasis from breast invasive ductal carcinoma in stages I-III of operable patients. Jpn J Clin Oncol 2009 Feb;39(2):97-.401
  10. Irawan C, Hukom R, Prayogo N. Factors associated with bone metastasis in breast cancer: a preliminary study in an Indonesian population. Acta Med Indones 2008 Oct;40(4):178-.08
  11. Alexandria TP, Vicente V, Bryan TH. Metastatic breast cancer. In: Kantarjian HM, Wolff RA, Koller CA, editors. The MD Anderson manual of medical oncology. New York:McGraw-Hill;2006:464.
  12. Theriault RL, Hortobagyi GN. Bone metastasis in breast cancer. Anticancer Drugs 1992 Oct;3(5):455-.26
  13. Mokarian F, Abdeyazdan N, Motamedi N, Tabesh P. [Risk factors of metastasis in women with breast cancer] [Article in Persian]. J Isfahan Med School 2012 Mar;29(171):1-.21

Files

Share

How to cite

Statistics