Uyeturk Ummugul, Budakoglu Burcin, Turker Ibrahim, Helvaci Kaan, Sonmez Ozlem Uysal, Aktas Gulali, Arslan Ulku Yalcintas, Oksuzoglu Omur Berna Cakmak
Abant İzzet Baysal University Faculty of Medicine, Department of Medical Oncology, Bolu, Turkey.
Ankara Oncology Education and Research Hospital, Clinical of Medical Oncology, Ankara, Turkey.
Contemp Oncol (Pozn). 2013;17(5):450-5. doi: 10.5114/wo.2013.37543. Epub 2013 Nov 14.
Breast cancer (BC) is a heterogeneous disease. Several subgroups have been identified, according to the clinical presentation and radiographic, pathological, biological, and molecular characteristics of the tumor. Intrinsic genetic heterogeneity may be responsible for these differences. To date, little is known about the clinical features and outcome of patients with primary metastatic BC (PMBC) defined as those presenting with stage IV disease.
Between September 2007 and May 2011, BC patients who were admitted to a clinic were assessed. Patients with PMBC were included in this retrospective analysis. The patients' demographic characteristics, treatment schedules, and survival data were recorded.
Of 2478 BC patients, 102 (4.1%) with PMBC were included in the analysis. The median age of the patients was 50 (26-90) years. Only four patients (3.9%) had previously undergone mammography. The median progression-free survival (PFS) and overall survival (OS) were 30 and 66 months, respectively. The PFS and OS were unaffected by age, menopausal status, ECOG, histology, or tumor grade. Both PFS and OS were affected by HR status (log rank p = 0.006, log rank p = 0.04), HER2 status (p = 0.001, p = 0.005), site of metastasis (p = 0.01, p = 0.04), radiotherapy (p = 0.04, OS p = 0.03), and bisphosphonate treatment (p = 0.02, p = 0.006). PFS was greater in the hormone therapy group (43 months, p = 0.03) while OS was greater in the patients that received chemotherapy (76 months, p = 0.01).
Mammography should be given greater emphasis, considering its importance in the prevention of PMBC. As a treatment option for bone and soft tissue metastatic PMBC patients, hormone therapy should be effective as a first-line treatment.
乳腺癌（BC）是一种异质性疾病。根据肿瘤的临床表现、影像学、病理、生物学和分子特征，已确定了几个亚组。内在基因异质性可能是造成这些差异的原因。迄今为止，对于被定义为IV期疾病患者的原发性转移性乳腺癌（PMBC）患者的临床特征和预后知之甚少。
2007年9月至2011年5月期间，对一家诊所收治的BC患者进行了评估。PMBC患者纳入本回顾性分析。记录患者的人口统计学特征、治疗方案和生存数据。
在2478例BC患者中，102例（4.1%）PMBC患者纳入分析。患者的中位年龄为50（26 - 90）岁。只有4例患者（3.9%）曾接受过乳腺X线摄影检查。中位无进展生存期（PFS）和总生存期（OS）分别为30个月和66个月。PFS和OS不受年龄、绝经状态、东部肿瘤协作组（ECOG）评分、组织学类型或肿瘤分级的影响。PFS和OS均受激素受体（HR）状态（对数秩检验p = 0.006，对数秩检验p = 0.04）、人表皮生长因子受体2（HER2）状态（p = 0.001，p = 0.005）、转移部位（p = 0.01，p = 0.04）、放疗（p = 0.04，OS p = 0.03）和双膦酸盐治疗（p = 0.02，p = 0.006）的影响。激素治疗组的PFS更长（43个月，p = 0.03），而接受化疗的患者OS更长（76个月，p = 0.01）。
鉴于乳腺X线摄影在预防PMBC中的重要性，应更加强调其应用。作为骨和软组织转移性PMBC患者的一种治疗选择，激素治疗作为一线治疗应是有效的。
