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. 2022 Jul;194(1):49-56.
doi: 10.1007/s10549-022-06591-7. Epub 2022 Apr 24.

Women with short survival after diagnosis of metastatic breast cancer: a population-based registry study

Caroline Boman  1   2 , Luisa Edman Kessler  3 , Jonas Bergh  3   4 , Alexios Matikas  3   4 , Theodoros Foukakis  3   4
Affiliations

Women with short survival after diagnosis of metastatic breast cancer: a population-based registry study

Caroline Boman et al. Breast Cancer Res Treat. 2022 Jul.

Abstract

Purpose: Despite therapeutic advances, overall survival of metastatic breast cancer (MBC) at the population level has seen little improvement over the past decades. Aggressive tumor biology or delay in access to cancer care might be contributing factors. With this retrospective population-based study we aimed to quantify and characterize patients with very short survival time following MBC diagnosis.

Methods: Women diagnosed with MBC between Jan 1st, 2005 and Dec 31st, 2016 were identified using the population-based Stockholm-Gotland breast cancer registry. Data regarding demographic and clinicopathological characteristics, survival, and treatment were extracted retrospectively from the registry and from patient charts. Patients who died within 90 days following diagnosis of MBC were identified and their characteristics were compared with all other patients diagnosed with MBC during the same period.

Results: Between 2005 and 2016, 3124 patients were diagnosed with MBC, of whom 498 (16.2%) died within 90 days of diagnosis. Nearly half (N = 233) did not receive any antitumoral treatment. Patients with short survival were older (p < 0.001), had higher primary tumor grade (p < 0.001), higher clinical stage at primary diagnosis (p = 0.002), and more often estrogen receptor (ER)-negative breast cancer (p < 0.001). Visceral metastases were more frequent (p < 0.001) and patients with short survival received adjuvant chemotherapy (p < 0.001) to a lesser extent compared to patients with a better prognosis. In multivariable analysis older age, time period of diagnosis, metastasis site, adjuvant chemotherapy, and primary tumor grade were independent predictors for short survival, whereas ER status was not.

Conclusion: Nearly one out of six patients with MBC survive less than 3 months after diagnosis. Our findings demonstrate a different spectrum of MBC at population level and can potentially inform on individualized follow-up strategies and treatment algorithms.

Keywords: Breast cancer; Metastatic; Population; Prognosis; Short survival.

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Conflict of interest statement

Caroline Boman and Luisa Edman Kessler have no conflicts of interest to disclose. Jonas Bergh received research funding from Merck paid to Karolinska Institutet and from Amgen, Bayer, Pfizer, Roche, and Sanofi-Aventis paid to Karolinska University Hospital. No personal payments. Payment from UpToDate for two chapters in breast cancer prediction paid to Asklepios Medicine HB. Alexios Matikas was a consultant to Veracyte, CA, USA (no financial compensation). Theodoros Foukakis received institutional grants from Roche and Pfizer and personal fees from Affibody, Novartis, Pfizer, Roche, Exact Sciences, Veracyte, and UpToDate.

Figures

Fig. 1
Fig. 1
Flowchart of patient selection and inclusion to study and control cohorts
Fig. 2
Fig. 2
Multivariable logistic regression for predictors of overall survival < 90 days from metastatic breast cancer diagnosis
See this image and copyright information in PMC

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