An analysis of the metastatic pattern of breast cancer in Uppsala Sweden: a retrospective cohort study
Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
Introduction: In Sweden breast cancer (BC) is the most common cancer in women with more than 8000 new cases every year. The reason for death in BC is the dissamination of the disease to other organs, so called metastatic breast cancer (MBC). The most common organs involved in MBC are skeleton, lung, liver, CNS, other visceral organs and soft tissue. BC have 4 different subtypes (Luminal A/B, triple negative, HER2-positive) and could also be classified based on histological growth pattern (ductal, lobular and other). There are insufficient information of the pattern of dissimation to the different organs acourding to BC subtypes. Aim: The primary aim of this cohort study was to examine the correlation between BC subtypes and the development of metastasis at distant organs. This information would advance the disease follow up. Materials and Methods: This is a retrospective clinical cohort study from patients treated in Uppsala between the years 2009 and 2014. The information was collected from the real time registry and medical records. The distant sites were classified as bone, lung/pleura, soft tissue, other visceral and CNS and the timing was defined in steps starting with M1 when patient first was defined as having MBC. The metastatic patterns at death were compared with the patterns at M1. Results: Totally 391 patients with MBC with a median age of 65 years were included. Median disease-free survival was 51 months. The development of metastases in new sites occurred in up to three distinguished steps, with median lag times of 22, 13 and 14 months, respectively. The median survival from M1 was 69, 37, 64 and 17 months for the luminal A, luminal B, HER2 and TN subtypes. Conclusion: The pattern of metastatic sites at M1 in different BC subtypes does not represent the pattern for development of new metastatic sites during the course of the disease. We observed a significantly different risk for developing new metastatic sites depending on subtypes, most obvious regarding liver metastases. TNBC seemed to have less ability to develop new metastatic sites.
Place, publisher, year, edition, pages
2015. , 41 p.
Metastatic Breast Cancer, disseminated cancer, Human Epidermal Growth Factor Receptor 2, Progesterone Receptor, Estrogen Receptor, Triple Negative
Cancer and Oncology
IdentifiersURN: urn:nbn:se:uu:diva-261756OAI: oai:DiVA.org:uu-261756DiVA: diva2:851181
Subject / course
Master of Science Programme in Pharmacy
Lindman, Henrik, MD PhD
Hammarlund-Udenaes, Margareta, Prof.