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Unfavourable pattern of metastases in M0 breast cancer patients during 1978-2008: a population-based analysis of the Munich Cancer Registry

  • Epidemiology
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Abstract

Little is known about time trends in metastases in the patients treated in routine health care facilities without metastases at diagnosis (M0) and about survival after these metastases. Data on 33,771 M0 patients with primary breast cancer diagnosed between 1978 and 2003 were obtained from the Munich Cancer Registry. Survival analyses were restricted to the patients with metastases within 5 years of the initial diagnosis. The incident number of the patients approximately doubled each period and 5-year overall survival increased from 77% in the first to 82% percent in the last period. 5490 (16%) M0 patients developed metastases within 5 years after the initial diagnosis. The hazard of developing metastases was lowest in the most recent period compared to the first period (HR = 0.50, P < 0.001). The hazard of dying after metastases was equal for patients diagnosed between 1978–1984 and 1995–2003 (HR 1.08, P = 0.3). The percentage of the patients that developed bone metastases decreased each time period, but the percentage primary liver and CNS metastases increased. Exclusion of site of metastases in the multivariate analysis led to a 20% (P = 0.02) higher hazard of dying following metastases in the last versus the first period. In the period 1978–2008, unfavourable changes in the pattern of metastases were exhibited and no improvement was observed in survival of the patients after occurrence of metastases. An explanation might be the increased use of adjuvant systemic treatment, which has less effect on the highly lethal liver and CNS metastases than on bone metastases. The increased use also appeared to contribute to the overall prevention of metastases in breast cancer and therefore to improve overall survival.

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All authors declared no conflict of interest.

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Authors and Affiliations

  1. Department of Clinical Oncology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands

    Corina J. G. van den Hurk & Johan W. R. Nortier

  2. Comprehensive Cancer Center South (IKZ), P. O. Box 231, 5600 AE, Eindhoven, The Netherlands

    Corina J. G. van den Hurk, Lonneke V. van de Poll-Franse, Jan Willem W. Coebergh & Wim P. M. Breed

  3. Munich Cancer Registry of the Munich Cancer Center, Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians University, Marchioninistraße 15, 81377, Munich, Germany

    Renate Eckel, Dieter Hölzel & Jutta Engel

  4. CoRPS—Center of Research on Psychology in Somatic Diseases, Tilburg University, P. O. Box 90153, 5000 LE, Tilburg, The Netherlands

    Lonneke V. van de Poll-Franse

  5. Department of Public Health, Erasmus University Medical Center, P. O. Box 2040, 3000 CA, Rotterdam, The Netherlands

    Jan Willem W. Coebergh

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  1. Corina J. G. van den Hurk
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Correspondence to Corina J. G. van den Hurk.

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van den Hurk, C.J.G., Eckel, R., van de Poll-Franse, L.V. et al. Unfavourable pattern of metastases in M0 breast cancer patients during 1978-2008: a population-based analysis of the Munich Cancer Registry. Breast Cancer Res Treat 128, 795–805 (2011). https://doi.org/10.1007/s10549-011-1372-y

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