Biopsy of breast cancer metastases: patient characteristics and survival Public Deposited

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Creator
  • Shafran, Noa
    • Other Affiliation: Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
  • Drumea, Karen
    • Other Affiliation: Division of Oncology, Rambam Health Care Campus, Haifa, Israel
  • Mashiach, Tanya
    • Other Affiliation: Statistical Department, Rambam Health Care Campus, Haifa, Israel
  • Fried, Georgeta
    • Other Affiliation: Division of Oncology, Rambam Health Care Campus, Haifa, Israel
  • Muss, Hyman B
  • Shachar, Shlomit S
    • Other Affiliation: Division of Oncology, Rambam Health Care Campus, Haifa, Israel
  • Bar-Sela, Gil
    • Other Affiliation: Division of Oncology, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Integrated Oncology and Palliative Care Unit, Rambam Health Care Campus, POB 9602, Haifa 31096, Israel
Abstract
  • 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.
Date of publication
Identifier
  • doi:10.1186/s12885-016-3014-6
Resource type
  • Article
Rights statement
  • In Copyright
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  • The Author(s).
Language
  • English
Bibliographic citation
  • BMC Cancer. 2017 Jan 04;17(1):7
Publisher
  • BioMed Central
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