Table 1.
Clinicopathologic characteristics and Survival in patients with isolated Breast cancer liver metastases
| Variable | All patients (n=167) | BCLM surgery (n=69) | BCLM medical (n=98) | P* |
|---|---|---|---|---|
| Demographics | ||||
| Age at diagnosis of primary breast tumor, years | 47 (39-57) | 47 (39-56) | 47( 40-59) | 0.2 |
| Age at diagnosis of BCLM, years | 52 (43-61 ) | 51 (43-59) | 52 (42-62) | 0.7 |
| Follow-up period1 (primary breast to last follow-up), months | 73 (46-135) | 89 (55-190) | 62 (42-100) | 0.09 |
| Follow-up period1 (From BCLM to last follow-up), months | 26 (12-48) | 31 (18-63) | 24 (10-43) | 0.1 |
| Time interval from breast cancer diagnosis to BCLM diagnosis, months | 42(16-82) | 53(27-94) | 30(8-46) | 0.001 |
| Breast Cancer | ||||
| Primary tumor, T | 0.5 | |||
| 1 | 53(43%) | 29(45%) | 24(41%) | |
| 2 | 59(48%) | 29(45%) | 30(52%) | |
| 3 | 8(7%) | 4(6%) | 4(7%) | |
| 4 | 2(2%) | 2(3%) | 0 | |
| Nodal status -negative | 66(46%) | 29(43%) | 37(49%) | 0.5 |
| American Joint Committee on Cancer (AJCC) staging (7th edition) | 0.07 | |||
| 1 | 24(19%) | 7(21%) | 17(19%) | |
| 2 | 38(31%) | 16(47%) | 22(25%) | |
| 3 | 28(23%) | 6(18%) | 22(25%) | |
| 4 | 33(27%) | 5(15%) | 28(31%) | |
| Tumor grade | 0.1 | |||
| 1 | 0 | 0 | 0 | |
| 2 | 32(24%) | 15(31%) | 17(20%) | |
| 3 | 104(76%) | 34(69%) | 70(80%) | |
| Histologic subtype | 0.06 | |||
| -Intraductal carcinoma | 143(93%) | 65(98%) | 84(89%) | |
| -Intralobular carcinoma | 4(2%) | 1(2%) | 3(3%) | |
| -Others e.g. mixed | 7(5%) | 0 | 7(7%) | |
| Estrogen Receptor(ER) status positive | 97(66%) | 42(78%) | 55(59%) | 0.02 |
| Progesterone Receptor(PR) status | 78(53%) | 32(59%) | 46(50%) | 0.3 |
| Human epidermal growth factor receptor 2 status positive§ | 47(38%) | 19(45%) | 28(34%) | 0.2 |
| Adjuvant chemotherapy after breast surgery# | 91(71%) | 52(81%) | 39(60%) | 0.008 |
| Adjuvant hormonal therapy after breast surgery# | 74(46%) | 31(51%) | 43(61%) | 0.4 |
| Adjuvant radiotherapy after breast surgery# | 81(50%) | 44(68%) | 37(53%) | <0.001 |
| Trastuzumab (Herceptin) treatment§ | 41(25%) | 11(16%) | 30(31%) | 0.03 |
| Type of breast surgery | <0.001 | |||
| -None | 27(16%) | 0 | 27(28%) | |
| -Breast Conservation Surgery | 65(39%) | 35(51%) | 30(31%) | |
| -Mastectomy | 73(45%) | 33(49%) | 40(41%) | |
| Breast cancer liver metastases | ||||
| Synchronous presentation | 35(21%) | 7(10%) | 28(29%) | 0.004 |
| Number of liver metastases | 2(1-4) | 1 (1-2) | 3 (1-6) | <0.001 |
| Number of liver metastases >5 | 39(24%) | 7(10%) | 32(34%) | <0.001 |
| Unilobar distribution | 95(59%) | 46(69%) | 49(52%) | 0.03 |
| Solitary | 73(44%) | 44(64%) | 29(30%) | <0.001 |
| Largest size, cm | 2.6 (1.7- 4.4) | 3(2-5) | 2.5(1.4- 4.1) | 0.04 |
| Largest tumor Size>5cm | 36(22%) | 18(26%) | 18(19%) | 0.3 |
| Cumulative size, cm | 4 (2.1-7) | 3.8(2-5.5) | 4.5(2.2-8) | 0.1 |
| Cumulative size>5cm | 69(43%) | 42(63%) | 51(54%) | 0.3 |
| Survival | ||||
| Overall survival from BCLM diagnosis , months median; 95%CI | 43(26-60) | 50(32-67) | 45(21-68) | 0.5 |
| 5 -year Overall survival from BCLM diagnosis, months %; 95%CI | 37%(27-47) | 38%(25-52) | 39%(24-53) | 0.98 |
Continuous variables are reported as median(IQR) and continuous variables as number (%); BCLM: Breast cancer liver metastasis
#
Only for patients who underwent breast surgery
*
p value is for analysis between the medical and surgical cohorts only, not for the entire study population
1
Follow-up calculated for survivors
§
The discrepancy in HER2 status and Herceptin treatment can be explained by patient refusing treatment, Herceptin not in clinical use yet or in some patients, HER2 was positive only in the liver metastasis but not in primary breast cancer.