Metastatic breast cancer: what does SEER say about site-specific survival?

  • Wang R & al.
  • BMC Cancer
  • 12 Nov 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A SEER analysis of site-specific survival with metastatic breast cancer (mBCa) finds that bone metastasis accounts for the most patients and has the best prognosis, at 50.5% for 3-year OS, whereas brain metastasis is the most infrequent site and has the worst prognosis, at 19.9%.

Why this matters

  • Clinicians and patients need to get the best prognostic information in order to make treatment and QoL decisions.

Study design

  • An analysis of 18,322 cases of mBCa in the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015).
  • Funding: None.

Key results

  • Frequency by metastatic site:
    • Bone-only: 39.8% of cohort.
    • Multiple: 33.07%.
    • Lung: 10.94%.
    • Other: 7.34%.
    • Brain: 1.51%.
  • 3-year OS by Kaplan-Meier method (best to worst):
    • Bone: 50.5%.
    • Other: 41.9%.
    • Liver: 38.2%.
    • Lung: 37.5%.
    • Multiple: 27.4%.
    • Brain: 19.9%.
  • 3-year breast cancer-specific survival by Kaplan-Meier method (best to worst):
    • Bone: 76.6%.
    • Liver: 67.7%.
    • Lung: 66.1%.
    • Other: 65.3%.
    • Multiple: 62.6%.
    • Brain: 50.6%.
  • Risk factors for poor survival (all HRs >1; all Ps<.001>
  • Unmarried marital status.
  • African descent.
  • High tumor grade.
  • Large tumor size.
  • Later N stage.
  • HER2+ subtype.
  • Triple-negative subtype.
  • Protective factors for better survival (all HRs
  • Married status.
  • Other race.
  • Receipt of chemotherapy, radiotherapy, and/or surgery.
  • Limitations

    • Retrospective observational design.