Clinical information and management status of de novo stage IV breast cancer patients: a Chinese multicenter investigation (CSBrS-002)

• Published in: Chinese medical journal 2021-06, Vol.134 (13), p.1569-1575
• Main Authors: Zheng, Ang, Guo, Bao-Liang, Zhang, Jian-Guo, Jin, Feng
• Format: Article
• Language: English
• Subjects: Age; Biomarkers, Tumor; Biopsy; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - surgery; Breast surgery; Cancer therapies; China; Clinical decision making; Epidermal growth factor; Estrogens; Family medical history; Female; Hospitalization; Humans; Lung cancer; Mammography; Mastectomy; Metastasis; Middle Aged; Original; Prognosis; Questionnaires; Receptor, ErbB-2; Receptors, Progesterone; Retrospective Studies; Statistical analysis; Tomography
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/CM9.0000000000001415

Although de novo stage IV breast cancer is so far incurable, it has entered an era of individualized treatment and chronic disease management. Based on systemic treatment, whether the surgical resection of primary or metastatic foci of de novo stage IV breast cancer can bring survival benefits is currently controversial. We aimed to explore the clinicopathological factors and current status of the management of de novo stage IV breast cancer in China to provide a reference for clinical decisions. Based on the assistance of Chinese Society of Breast Surgery, a retrospective study was conducted to analyze the clinical data of patients with de novo stage IV breast cancer in 33 centers from January 2017 to December 2018. The relationship between basic characteristic (age, menstrual status, family history, reproductive history, pathological type, estrogen receptor [ER] status, progesterone receptor [PR] status, human epidermal growth factor receptor 2 [HER2] status, Ki-67 percentage, and molecular subtype), and metastasis sites (lung metastasis, liver metastasis, and bone metastasis) was examined by Pearson Chi-square tests. A total of 468 patients with de novo stage IV breast cancer were enrolled. The median age of the enrolled patients was 51.5 years. The most common pathological type of primary lesion was invasive carcinoma (97.1%). Luminal A, luminal B, HER2 overexpressing, and triple-negative subtypes accounted for 14.3%, 51.8%, 22.1%, and 11.8% of all cases, respectively. Age, PR status, and HER2 status were correlated with lung metastasis (χ2 = 6.576, 4.117, and 8.643 and P = 0.037, 0.043, and 0.003, respectively). Pathological type, ER status, PR status, and molecular subtype were correlated with bone metastasis (χ2 = 5.117, 37.511, 5.224, and 11.603 and P = 0.024,