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. 2017 Jan 4;17(1):7.
doi: 10.1186/s12885-016-3014-6.

Biopsy of breast cancer metastases: patient characteristics and survival

Shlomit Strulov Shachar  1 , Tanya Mashiach  2 , Georgeta Fried  1 , Karen Drumea  1 , Noa Shafran  3 , Hyman B Muss  4 , Gil Bar-Sela  5   6   7
Affiliations

Biopsy of breast cancer metastases: patient characteristics and survival

Shlomit Strulov Shachar et al. BMC Cancer. .

Abstract

Background: Discordance in hormone receptors (HR) and human epidermal growth factor receptor 2 (HER2) status between primary tumors and metastatic sites for breast cancer is well established. However, it is uncertain which patient-related factors lead to biopsy when metastases are suspected and whether having a biopsy impacts survival.

Methods: The medical charts of metastatic breast cancer (MBC) patients diagnosed January 2000-August 2014 were retrospectively reviewed. A biopsy was defined as a procedure where tissue was obtained and assessed for both HR and HER2. Both bivariate and multivariate analyses were performed to assess patient characteristics related to biopsy and whether having a biopsy was associated with improved survival.

Results: Of 409 patients suspected of having MBC, 165 (40%) had a biopsy, and 34% of these had discordant HR or HER2 status when compared to the initial diagnosis. In multivariate analysis, having a biopsy was associated with: recurrence in years 2010-2014, disease-free interval of > =3 years, stage 0-IIA at presentation, suspected locoregional recurrence, being HR+/HER2-, or missing HR/HER2 at diagnosis. A similar multivariate analysis revealed that having a biopsy was associated with improved survival (HR = 0.67, p = 0.002). The association of biopsy and improved survival was noted in specific subgroups: patients with missing HR and HER2 data at initial diagnosis (p = 0.001), those without metastases in liver, lung or brain (p = 0.001), and being younger than 70 years old at recurrence (p < 0.001).

Conclusions: Specific clinical factors were associated with biopsy at the time of suspected recurrence. Having a biopsy was associated with reduced mortality.

Keywords: Biopsy; Breast carcinoma; Pathology; Recurrent-metastatic disease; Survival.

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Figures

Fig. 1
Fig. 1
Discordance between initial histology and biopsy (n = 107)
See this image and copyright information in PMC

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