Effect of Breast Cancer Molecular Subtypes on Survival in Patients with Liver Metastases

This is the authors' abstract. We don't add key points for this paper.

Background: The liver is one of the most common metastatic sites of breast cancer, hepatic metastases develop in 6%-25% of patients with breast cancer and being associated with a poor prognosis. The aim of this study was to analyze the clinical characteristics and survival of patients with different molecular breast cancer subtypes who developed hepatic metastases (HM), and to investigate the prognostic and predictive factors that affect clinical outcome.Methods: A retrospective study of 63 early breast cancer patients (stage І&П) who developed hepatic metastases, diagnosed at Menoufia University Hospital, Clinical Oncology Department from 1st of January 2000 to 31 of May 2007. Molecular Subtypes were defined as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) enriched, triple-negative (TN). Prognostic factors correlation with clinical features and treatment approaches were assessed after diagnosis of HM.Results: Median Overall Survival (OS) of all breast cancer patients with HM is 35 months, with statistically significant median OS among breast cancer molecular subtypes: luminal A, luminal B, HER2 enriched and TN (P=0.02), Median OS was 33.27, 45.75, 34.14, 30 months respectively. In multivariate analysis, the initial disease stage and the number of hepatic metastases are the independent predictors of prognosis. Luminal A group of patients who were treated with endocrine therapy didn't significantly improve more than patients treated without endocrine therapy when indicated (median survival of 35 vs. 30 months, P=0.19). Similarly there were no significant differences in Luminal B group (P=0.13). However, a good tendency for better median survival for patients treated with endocrine therapy was found as median survival is 48 months Vs 40 months in patients not treated with endocrine therapy after metastases. Endocrine therapy was a significantly favorable prognostic factor for luminal subtype patients, who were initially treated with adjuvant endocrinetherapy (P=0.03).Conclusions: Breast cancer molecular subtypes were associated with survival benefit difference after hepatic metastases. Endocrine therapy was a significantly favorable treatment for patients with luminal subtypes.