Prognostic factors in 1,038 women with metastatic breast cancer

Abstract

Background: Treatment of metastatic breast cancer (MBC) remains palliative. Patients with MBC represent a heterogeneous group whose prognosis and outcome may be dependent on host factors. The purpose of the present study was dual: first, to draw up a list of factors easily available in everyday clinical practice requiring no sophisticated or costly methods and second, to provide results from a large cohort of women who underwent diagnostic and treatment at a single institution.

Patients and methods: From 1975 to 2005, a total of 1,038 women with MBC during their follow-up were included in this retrospective analysis. Patients were subsequently assigned to five groups according to the period of metastatic diagnosis.

Results: It is shown that age at initial diagnosis, hormonal receptor status and site of metastasis are the most relevant prognostic factors for predicting survival from the time of metastastic occurrence. It is also shown that a metastasis-free interval is an easily and immediately available multifactorial prognostic index reflecting the multiparametric variability of the disease.

Conclusion: These fundamental observations may assist physicians in evaluating the survival potential of patients and in directing them toward the appropriate therapeutic decision.

Figure 1.

Plot of the fitted spline function for log (hazard ratio) of metastasis-free interval (MFI) (dashed lines show the 95% confidence intervals). Risk of death declines with increasing MFI.

Figure 2.

Survival from the time of diagnosis of metastatic disease for patients with hormonal receptor positive (HR+) according to the period of diagnosis of the first metastasis recurrence.

Figure 3.

Survival from the time of diagnosis of metastatic disease for patients with hormonal receptor negative (HR−) according to the period of diagnosis of the first metastasis recurrence.

Figure 4.

Survival from the time of diagnosis of metastatic disease for patients with hormonal receptor positive (HR+) according to the localization of the first metastasis recurrence.

Figure 5.

Survival from the time of diagnosis of metastatic disease for patients with hormonal receptor positive (HR−) according to the localization of the first metastasis recurrence.