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. 2017 Apr 18;8(16):26368-26379.
doi: 10.18632/oncotarget.14300.

The prognosis analysis of different metastasis pattern in patients with different breast cancer subtypes: a SEER based study

Haiyong Wang  1 , Chenyue Zhang  2 , Jingze Zhang  1 , Li Kong  1 , Hui Zhu  1 , Jinming Yu  1
Affiliations

The prognosis analysis of different metastasis pattern in patients with different breast cancer subtypes: a SEER based study

Haiyong Wang et al. Oncotarget. .

Abstract

Studies on prognosis of different metastasis patterns in patients with different breast cancer subtypes (BCS) are limited. Therefore, we identified 7862 breast cancer patients with distant metastasis from 2010 to 2013 using Surveillance, Epidemiology, wand End Results (SEER) population-based data. The results showed that bone was the most common metastatic site and brain was the least common metastatic site, and the patients with HR+/HER2- occupied the highest metastasis proportion, the lowest metastasis proportion were found in HR-/HER2+ patients. Univariate and multivariate logistic regression analysis were used to analyze the association, and it was found that there were significant differences of distant metastasis patterns in patients with different BCS(different P value). Importantly, univariate and multivariate Cox regression analysis were used to analyze the prognosis. It was proven that only bone metastasis was not a prognostic factor in the HR+/HER2-, HR+/HER2+ and HR-/HER2+ subgroup (all, P > 0.05), and patients with brain metastasis had the worst cancer specific survival (CSS) in all the subgroups of BCS (all, P<0.01). Interestingly, for patients with two metastatic sites, those with bone and lung metastasis had best CSS in the HR+/HER2- (P<0.001) and HR+/HER2+ subgroups (P=0.009) However, for patients with three and four metastatic sites, there was no statistical difference in their CSS (all, P>0.05).

Keywords: SEER; breast cancer; breast cancer subtypes; metastasis pattern; prognosis.

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Conflict of interest statement

CONFLICTS OF INTEREST

All authors have reviewed the final version of the manuscript and approve it for publication. This manuscript has not been published in whole or in part nor is it being considered for publication elsewhere. The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. The percentage of distant metastasis sites
A. The percentage of distant metastasis sites based on different BCS. B. The percentage of BCS based on different distant metastasis sites.
Figure 2
Figure 2. The percentage of distant combination metastasis
A. The percentage of different distant combination metastasis based on different BCS in all the patients. B. The percentage of all different distant combination metastasis in patients with specific BCS.
Figure 3
Figure 3. The CSS curves in breast cancer patients with different distant metastasis sites
A. the CSS curves in breast cancer patients with different BCS according to bone metastasis pattern (bone: χ2=366.1, P<0.001). B. the CSS curves in breast cancer patients with different BCS according to lung metastasis pattern (lung: χ2=182.4, P<0.001). C. the CSS curves in breast cancer patients with different BCS according to liver metastasis pattern (liver: χ2=135.1, P<0.001). D. the CSS curves in breast cancer patients with different BCS according to brain metastasis pattern (brain: χ2=32.62, P<0.001).
Figure 4
Figure 4. The CSS curves in breast cancer patients with different distant combination metastasis sites
A. the CSS curves in breast cancer patients with only one distant metastasis site according to different BCS (HR+/HER2-: χ2=29.70, P<0.001; HR+/HER2+:χ2=3.610, P=0.308; HR-/HER2+:χ2=8.461, P=0.037; HR-/HER2-:χ2=5.385, P=0.147). B. the CSS curves in breast cancer patients with two distant metastasis sites according to different BCS (HR+/HER2-:χ2=33.12, P<0.001; HR+/HER2+:χ2=11.49, P=0.009; HR-/HER2+:χ2=0.260, P=0.967; HR-/HER2-:χ2=4.347, P=0.226). C. the CSS curves in breast cancer patients with three distant metastasis sites according to different BCS (HR+/HER2-: χ2=0.494, P=0.482; HR+/HER2+: χ2=0.990, P=0.320; HR-/HER2+: χ2=1.212, P=0.271; HR-/HER2-: χ2=0.313, P=0.576). D. the CSS curves in breast cancer patients with four distant metastasis sites according to different BCS (χ2=4.918, P=0.178).
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