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Survival among patients with untreated metastatic breast cancer: "What if I do nothing?".

Publication ,  Journal Article
Plichta, JK; Thomas, SM; Wang, X; McDuff, SGR; Kimmick, G; Hwang, ES
Published in: Breast Cancer Res Treat
June 2024

PURPOSE: We sought to assess survival outcomes of patients with de novo metastatic breast cancer (dnMBC) who did not receive treatment irrespective of the reason. METHODS: Adults with dnMBC were selected from the NCDB (2010-2016) and stratified based on receipt of treatment (treated = received at least one treatment and untreated = received no treatments). Overall survival (OS) was estimated using the Kaplan-Meier method, and groups were compared. Cox proportional hazards models were used to identify factors associated with OS. RESULTS: Of the 53,240 patients with dnMBC, 92.1% received at least one treatment (treated), and 7.9% had no documented treatments, irrespective of the reason (untreated). Untreated patients were more likely to be older (median 68 y vs 61 y, p < 0.001), have higher comorbidity scores (p < 0.001), have triple-negative disease (17.8% vs 12.6%), and a higher disease burden (≥ 2 metastatic sites: 38.2% untreated vs 29.2% treated, p < 0.001). The median unadjusted OS in the untreated subgroup was 2.5 mo versus 36.4 mo in the treated subgroup (p < 0.001). After adjustment, variables associated with a worse OS in the untreated cohort included older age, higher comorbidity scores, higher tumor grade, and triple-negative (vs HR + /HER2-) subtype (all p < 0.05), while the number of metastatic sites was not associated with survival. CONCLUSIONS: Patients with dnMBC who do not receive treatment are more likely to be older, present with comorbid conditions, and have clinically aggressive disease. Similar to those who do receive treatment, survival in an untreated population is associated with select patient and disease characteristics. However, the prognosis for untreated dnMBC is dismal.

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Published In

Breast Cancer Res Treat

DOI

EISSN

1573-7217

Publication Date

June 2024

Volume

205

Issue

2

Start / End Page

333 / 347

Location

Netherlands

Related Subject Headings

  • Proportional Hazards Models
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Metastasis
  • Middle Aged
  • Kaplan-Meier Estimate
  • Humans
  • Female
  • Comorbidity
  • Breast Neoplasms
 

Citation

APA
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MLA
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Plichta, J. K., Thomas, S. M., Wang, X., McDuff, S. G. R., Kimmick, G., & Hwang, E. S. (2024). Survival among patients with untreated metastatic breast cancer: "What if I do nothing?". Breast Cancer Res Treat, 205(2), 333–347. https://doi.org/10.1007/s10549-024-07265-2
Plichta, Jennifer K., Samantha M. Thomas, Xuanji Wang, Susan G. R. McDuff, Gretchen Kimmick, and E Shelley Hwang. “Survival among patients with untreated metastatic breast cancer: "What if I do nothing?".Breast Cancer Res Treat 205, no. 2 (June 2024): 333–47. https://doi.org/10.1007/s10549-024-07265-2.
Plichta JK, Thomas SM, Wang X, McDuff SGR, Kimmick G, Hwang ES. Survival among patients with untreated metastatic breast cancer: "What if I do nothing?". Breast Cancer Res Treat. 2024 Jun;205(2):333–47.
Plichta, Jennifer K., et al. “Survival among patients with untreated metastatic breast cancer: "What if I do nothing?".Breast Cancer Res Treat, vol. 205, no. 2, June 2024, pp. 333–47. Pubmed, doi:10.1007/s10549-024-07265-2.
Plichta JK, Thomas SM, Wang X, McDuff SGR, Kimmick G, Hwang ES. Survival among patients with untreated metastatic breast cancer: "What if I do nothing?". Breast Cancer Res Treat. 2024 Jun;205(2):333–347.
Journal cover image

Published In

Breast Cancer Res Treat

DOI

EISSN

1573-7217

Publication Date

June 2024

Volume

205

Issue

2

Start / End Page

333 / 347

Location

Netherlands

Related Subject Headings

  • Proportional Hazards Models
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Metastasis
  • Middle Aged
  • Kaplan-Meier Estimate
  • Humans
  • Female
  • Comorbidity
  • Breast Neoplasms