Boaitey Gloria Agyekum, Martini Rachel, Stonaker Brian, Bonsu Ernest Osei, Adjei Ernest, Kyei Ishmael, Ansah Mavis Bobie, Newman Lisa, Obirikorang Christian, Davis Melissa B, Fondjo Linda Ahenkorah
Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Institute of Translational Genomic Medicine, Morehouse School of Medicine, Atlanta, GA, USA.
BMC Cancer. 2024 Dec 2;24(1):1485. doi: 10.1186/s12885-024-13254-x.
Significant advances have been made in targeted therapeutics and systemic therapy regimens for breast cancer (BC) treatment over the past decade. Tumour cells can however remain in the body, leading to locoregional relapse and/or metastasis. Subtypes of BC have distinct prognostic effects and have been linked to varying risks of early locoregional relapse and metastases, response to treatment, and overall survival. Most Low- and middle-income countries (LMICs) have no registries of BC locoregional relapse and metastasis.
This study comprehensively reviewed, a 3-year retrospective single-centre data of female BC visiting the Komfo Anokye Teaching Hospital (KATH), Ghana to determine the prevalence of locoregional relapse and metastasis across our patient population. Prevalence of metastasis among the various BC subtypes was also determined.
Prevalence of BC locoregional relapse and metastasis were 3.4% and 47.6% respectively. For BC patients with documented locoregional relapse (N = 36), 27.8% (CI = 15.8 - 44.0%) had relapse to the contralateral breast, 41.7% (CI = 27.1 - 57.8%) had relapse to the ipsilateral breast, and 30.6% (CI = 18.0 - 46.9%) had relapse to regional lymph nodes. For BC patients with documented metastasis (N = 503), 151 (30%) had multiple organs involvement, 141 (28%) had lung metastases, 80 (16%) had bone metastases, 45 (9%) had liver metastases, 16 (3%) had brain metastases and 70 (14%) had other metastases (ovary, uterus, spleen, peritoneum, or distant lymph nodes). Basal subtype was the most common subtype (n = 82, 41%), followed by Luminal A (n = 69, 34.5%), HER2+ (n = 37, 18.5%) and Luminal B (n = 12, 6%). Basal subtypes had the most metastasis (35%), with multiple metastasis being the most prevalent (13%).
Close to half of the patients (46%) presented with metastatic BC. BC subtypes could influence the specific metastatic site. The most common BC subtype was the Basal subtype and had the most metastases (35%), with multiple metastasis being the most prevalent (13%). These findings should serve as a guide in the management of patients to enhance early prediction and detection of locoregional relapse and metastasis for improved overall treatment outcomes.
在过去十年中，乳腺癌（BC）治疗的靶向治疗和全身治疗方案取得了重大进展。然而，肿瘤细胞仍可残留在体内，导致局部区域复发和/或转移。BC的亚型具有不同的预后影响，并与早期局部区域复发和转移、治疗反应及总生存期的不同风险相关。大多数低收入和中等收入国家（LMICs）没有BC局部区域复发和转移的登记数据。
本研究全面回顾了加纳Komfo Anokye教学医院（KATH）为期3年的女性BC单中心回顾性数据，以确定我们患者群体中局部区域复发和转移的患病率。还确定了各种BC亚型中的转移患病率。
BC局部区域复发和转移的患病率分别为3.4%和47.6%。对于有记录的局部区域复发的BC患者（N = 36），27.8%（CI = 15.8 - 44.0%）复发至对侧乳房，41.7%（CI = 27.1 - 57.8%）复发至同侧乳房，30.6%（CI = 18.0 - 46.9%）复发至区域淋巴结。对于有记录的转移的BC患者（N = 503），151例（30%）有多个器官受累，141例（28%）有肺转移，80例（16%）有骨转移，45例（9%）有肝转移，16例（3%）有脑转移，70例（14%）有其他转移（卵巢、子宫、脾脏、腹膜或远处淋巴结）。基底亚型是最常见的亚型（n = 82，41%），其次是腔面A型（n = 69，34.5%）、HER2+型（n = 37，18.5%）和腔面B型（n = 12，6%）。基底亚型转移最多（35%），其中多发转移最为常见（13%）。
近一半的患者（46%）表现为转移性BC。BC亚型可能影响特定的转移部位。最常见的BC亚型是基底亚型，转移最多（35%），其中多发转移最为常见（13%）。这些发现应作为患者管理的指南，以加强局部区域复发和转移的早期预测和检测，从而改善总体治疗结果。
