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Survival Outcomes Among Patients with Metastatic Breast Cancer: Review of 47,000 Patients.

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Taskindoust, M; Thomas, SM; Sammons, SL; Fayanju, OM; DiLalla, G; Hwang, ES; Plichta, JK
Published in: Ann Surg Oncol
November 2021

BACKGROUND: Although metastatic breast cancer (MBC) remains incurable, advances in therapies have improved survival. Using a contemporary dataset of de novo MBC patients, we explore how overall (OS) and cancer-specific survival (CSS) changed over time. METHODS: All patients with de novo MBC from 1988 to 2016 were selected from Surveillance, Epidemiology, and End Results (SEER) 18. Unadjusted OS and CSS were estimated by Kaplan-Meier method and stratified by disease characteristics. Cox proportional hazards models determined factors associated with survival. RESULTS: 47,034 patients were included, with median OS of 25 months and CSS of 27 months. Survival steadily improved over time (1988: 1-year OS 62%, CSS 65%; 2015: 1-year OS 72%, CSS 74%). Patients with triple-negative breast cancer (TNBC) had the worst prognosis and were most likely to die from MBC [versus human epidermal growth factor receptor 2 (HER2)+ and hormone receptor (HR)+/HER2-]. Those with ≥ 4 sites of metastatic disease were also more likely to die from MBC with nearly identical OS and CSS (5-year OS 9%, CSS 9%), when compared with those with 1 site (5-year OS 31%, CSS 35%). After adjustment, improved CSS was associated with bone-only disease [hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.83-0.94], while TNBC (versus HER2+: HR 3.12, 95% CI 2.89-3.36) and > 3 sites of metastatic disease (versus 1 site: HR 3.24, 95% CI 2.68-3.91) were associated with worse CSS (all p < 0.001). CONCLUSIONS: Accurate prognostic estimates are essential for patient care. As treatments for patients with MBC have expanded, OS and CSS have improved, and more patients, particularly with limited distant disease or favorable tumor subtypes, are also dying from non-MBC causes.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

November 2021

Volume

28

Issue

12

Start / End Page

7441 / 7449

Location

United States

Related Subject Headings

  • Triple Negative Breast Neoplasms
  • Proportional Hazards Models
  • Prognosis
  • Oncology & Carcinogenesis
  • Humans
  • Female
  • Breast Neoplasms
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

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Taskindoust, M., Thomas, S. M., Sammons, S. L., Fayanju, O. M., DiLalla, G., Hwang, E. S., & Plichta, J. K. (2021). Survival Outcomes Among Patients with Metastatic Breast Cancer: Review of 47,000 Patients. In Ann Surg Oncol (Vol. 28, pp. 7441–7449). United States. https://doi.org/10.1245/s10434-021-10227-3
Taskindoust, Mahsa, Samantha M. Thomas, Sarah L. Sammons, Oluwadamilola M. Fayanju, Gayle DiLalla, E Shelley Hwang, and Jennifer K. Plichta. “Survival Outcomes Among Patients with Metastatic Breast Cancer: Review of 47,000 Patients.” In Ann Surg Oncol, 28:7441–49, 2021. https://doi.org/10.1245/s10434-021-10227-3.
Taskindoust M, Thomas SM, Sammons SL, Fayanju OM, DiLalla G, Hwang ES, et al. Survival Outcomes Among Patients with Metastatic Breast Cancer: Review of 47,000 Patients. In: Ann Surg Oncol. 2021. p. 7441–9.
Taskindoust, Mahsa, et al. “Survival Outcomes Among Patients with Metastatic Breast Cancer: Review of 47,000 Patients.Ann Surg Oncol, vol. 28, no. 12, 2021, pp. 7441–49. Pubmed, doi:10.1245/s10434-021-10227-3.
Taskindoust M, Thomas SM, Sammons SL, Fayanju OM, DiLalla G, Hwang ES, Plichta JK. Survival Outcomes Among Patients with Metastatic Breast Cancer: Review of 47,000 Patients. Ann Surg Oncol. 2021. p. 7441–7449.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

November 2021

Volume

28

Issue

12

Start / End Page

7441 / 7449

Location

United States

Related Subject Headings

  • Triple Negative Breast Neoplasms
  • Proportional Hazards Models
  • Prognosis
  • Oncology & Carcinogenesis
  • Humans
  • Female
  • Breast Neoplasms
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis