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Survival and disease characteristics of de novo versus recurrent metastatic breast cancer in a cohort of young breast cancer patients

Survival and disease characteristics of de novo versus recurrent metastatic breast cancer in a cohort of young breast cancer patients
Survival and disease characteristics of de novo versus recurrent metastatic breast cancer in a cohort of young breast cancer patients
Abstract

BACKGROUND: It is not clear how the pathology, presentation and outcome for patients who present with de novo metastatic breast cancer (dnMBC) compare to those who later develop distant metastases. DnMBC is uncommon in younger patients. We describe these differences within a cohort of young patients in the UK.
METHODS: Women aged 40 years or younger with a first invasive breast cancer were recruited to the prospective POSH national cohort study. Baseline clinicopathological data were collected, with annual follow-up. Overall survival (OS) and post-distant relapse-free survival (PDRS) were assessed using Kaplan-Meier curves.
RESULTS: 862 patients were diagnosed with metastatic disease. DnMBC prevalence was 2.6% (76/2977). Of those with initially localised disease, 27.1% (786/2901) subsequently developed a distant recurrence. Median follow-up was 11.00 years (95% CI 10.79-11.59). Patients who developed metastatic disease within 12 months had worse OS than dnMBC patients (HR 2.64; 1.84-3.77). For PDRS, dnMBC was better than all groups, including those who relapsed after five years. Of dnMBC patients, 1.3% had a gBRCA1 and 11.8% a gBRCA2 mutation.
CONCLUSIONS: Young women with dnMBC have better PDRS than those who develop relapsed metastatic breast cancer. A gBRCA2 mutation was overrepresented in dnMBC.
0007-0920
1618-1629
McKenzie, Hayley
bf6b2abc-6bb7-4df9-bb2d-db3847410af4
Maishman, Tom
cf4259a4-0eef-4975-9c9d-a2c3d594f989
Simmonds, Peter
27d4c068-e352-4cbf-9899-771893788ade
Durcan, Lorraine
bd059b41-9e77-4afe-b271-9ac4c91a05c6
Eccles, Diana
5b59bc73-11c9-4cf0-a9d5-7a8e523eee23
Copson, Ellen
a94cdbd6-f6e2-429d-a7c0-462c7da0e92b
Posh Steering Group
McKenzie, Hayley
bf6b2abc-6bb7-4df9-bb2d-db3847410af4
Maishman, Tom
cf4259a4-0eef-4975-9c9d-a2c3d594f989
Simmonds, Peter
27d4c068-e352-4cbf-9899-771893788ade
Durcan, Lorraine
bd059b41-9e77-4afe-b271-9ac4c91a05c6
Eccles, Diana
5b59bc73-11c9-4cf0-a9d5-7a8e523eee23
Copson, Ellen
a94cdbd6-f6e2-429d-a7c0-462c7da0e92b

McKenzie, Hayley, Maishman, Tom, Simmonds, Peter, Durcan, Lorraine, Eccles, Diana and Copson, Ellen , Posh Steering Group (2020) Survival and disease characteristics of de novo versus recurrent metastatic breast cancer in a cohort of young breast cancer patients. British Journal of Cancer, 122 (11), 1618-1629, [CL-2019-6197R]. (doi:10.1038/s41416-020-0784-z).

Record type: Article

Abstract

Abstract

BACKGROUND: It is not clear how the pathology, presentation and outcome for patients who present with de novo metastatic breast cancer (dnMBC) compare to those who later develop distant metastases. DnMBC is uncommon in younger patients. We describe these differences within a cohort of young patients in the UK.
METHODS: Women aged 40 years or younger with a first invasive breast cancer were recruited to the prospective POSH national cohort study. Baseline clinicopathological data were collected, with annual follow-up. Overall survival (OS) and post-distant relapse-free survival (PDRS) were assessed using Kaplan-Meier curves.
RESULTS: 862 patients were diagnosed with metastatic disease. DnMBC prevalence was 2.6% (76/2977). Of those with initially localised disease, 27.1% (786/2901) subsequently developed a distant recurrence. Median follow-up was 11.00 years (95% CI 10.79-11.59). Patients who developed metastatic disease within 12 months had worse OS than dnMBC patients (HR 2.64; 1.84-3.77). For PDRS, dnMBC was better than all groups, including those who relapsed after five years. Of dnMBC patients, 1.3% had a gBRCA1 and 11.8% a gBRCA2 mutation.
CONCLUSIONS: Young women with dnMBC have better PDRS than those who develop relapsed metastatic breast cancer. A gBRCA2 mutation was overrepresented in dnMBC.

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POSH M0 M1 v11 BJC tracked - Accepted Manuscript
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Accepted/In Press date: 14 February 2020
e-pub ahead of print date: 31 March 2020

Identifiers

Local EPrints ID: 439147
URI: http://eprints.soton.ac.uk/id/eprint/439147
ISSN: 0007-0920
PURE UUID: 37232193-012d-453a-86b4-ce8356229859
ORCID for Diana Eccles: ORCID iD orcid.org/0000-0002-9935-3169

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Date deposited: 06 Apr 2020 16:30
Last modified: 26 Nov 2021 06:15

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Contributors

Author: Hayley McKenzie
Author: Tom Maishman
Author: Peter Simmonds
Author: Lorraine Durcan
Author: Diana Eccles ORCID iD
Author: Ellen Copson
Corporate Author: Posh Steering Group

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