Clinical Characteristics And Prognosis Of Patients With Metastases From Different Sites Of Breast Cancer

Background and objective:Advanced breast cancer seriously affects the survival and quality of life of patients,yet there are few studies on the characteristics and prognosis of patients with advanced breast cancer with different metastatic sites.The aim of this study was to explore the clinicopathological characteristics,treatment modalities,and prognosis of patients with advanced breast cancer with different metastatic sites.Methods:A retrospective analysis of patients who attended the First Hospital of Jilin University and were diagnosed with advanced breast cancer from 2017-2023.KaplanMeier curves,log-rank tests and Cox proportional risk models were used to assess the association of time from diagnosis of metastasis to disease progression and death.Results:A total of 757 patients with advanced breast cancer were included in this study,with the following key findings.1.251 cases of bone metastases,229 cases of lung metastases(including 10 cases of lung cancerous lymphangitis),172 cases of liver metastases,51 cases of brain metastases,21 cases of meningeal metastases and 33 cases of bone marrow metastases.Molecular typing was most common for hormone receptor positive and human epidermal growth factor receptor 2 negative(HR+,HER-2-)(490 cases,64.72%),and the pathological type was mainly invasive ductal carcinoma(711 cases,93.92%).2.There were differences in survival times for patients with different metastatic sites.Patients with bone metastases had the best prognosis,with a median overall survival(m OS)of 33.69 months(2.3-89.7 months),35.57 months(3.1-89.7 months)for bone metastases alone,and 24.01 months(2.3-55.2 months)for patients with bone metastases combined with visceral metastases.The m OS was 25.46 months(2.2-79.6months)for patients with lung metastases,24.06 months(3.4-71.9)for patients with liver metastases,18.91 months(2.0-55.9 months)for patients with brain metastases and18.0 months(2.0-107.8 months)for patients with bone marrow metastases.3.In 90 patients with bone marrow metastases,diffuse liver metastases and meningeal metastases using different treatment regimens,m OS was 8 months(1-60)in the chemotherapy group and 24 months(3-108 months)in the endocrine group.the Cox proportional risk model suggested that different metastasis types,age,molecular typing and histological grading were associated with patient prognosis.Conclusions:1.Bone is the most common site of metastasis in metastatic breast cancer.The molecular typing was HR+ and HER-2-,and the pathological type was invasive ductal carcinoma.HR+ and HER-2-patients were more likely to develop brain metastases.2.Patients with simple bone metastases have the best prognosis,while those with diffuse liver metastases have the worst prognosis.3.For patients with rapidly progressive bone marrow metastases,diffuse liver metastases and meningeal metastases and for those who can tolerate further treatment compared to conventional chemotherapy,the use of CDK4/6 inhibitors + aromatase inhibitors or molecularly targeted combination chemotherapy can significantly prolong survival and improve the quality of survival.