Table 2.
Characteristics of the 730 secondary metastatic patients, at the moment of metastatic disease
| Mean age at diagnosis of metastatic disease, yearsa | 60 ± 7 |
| Trigger for further investigation that led to diagnosis of metastases, n/N (%) | |
| History | 348/730 (48) |
| CA 15.3 elevation | 269/730 (37) |
| Accidental finding | 55/730 (7) |
| Clinical examination | 27/730 (4) |
| Other laboratory changes | 31/730 (4) |
| Disturbed laboratory values (other than CA 15.3) that led to the diagnosis of metastases, n/N (%) | |
| Elevated aspartate aminotransferase or alanine aminotransferase | 1/31 (3) |
| Elevated gamma-glutamyltransferase or alkaline phosphatase | 4/31 (13) |
| Elevation of all liver enzymes | 20/31 (65) |
| Hypercalcaemia | 4/31 (13) |
| Elevated carcinoembryonic antigen | 1/31 (3) |
| Elevated lactate dehydrogenase | 1/31 (3) |
| Number of patients in whom diagnosis of metastases was made by CA 15.3 increase, in relation to breast cancer subtype, n/N (%) | |
| Luminal A-like | 128/264 (48) |
| Luminal HER2-like | 23/52 (44) |
| Luminal B-like | 80/215 (37) |
| HER2-like | 17/56 (30) |
| Triple-negative | 21/143 (15) |
| Number of patients in whom diagnosis of metastases was made by CA 15.3 increase, in relation to age at diagnosis of early breast cancer, n/N (%) | |
| ≤50 Years old, diagnosed by CA 15.3 increase | 90/276 (33) |
| >50 Years old, diagnosed by CA 15.3 increase | 179/454 (39) |
| Number of patients in whom diagnosis of metastases was made by CA 15.3 increase, in relation to tumour stage at diagnosis of early breast cancer, n/N (%)19 | |
| Stage 1, diagnosed by CA 15.3 increase | 30/85 (35) |
| Stage 2, diagnosed by CA 15.3 increase | 102/300 (34) |
| Stage 3, diagnosed by CA 15.3 increase | 137/345 (40) |
| Localisation of distant metastases, n/N (%) | |
| Localised in 1 organ | 396/730 (54) |
| Localised in multiple organs | 334/730 (46) |
| Specific localisation per organ (several affected organs jointly are possible), n/N (%) | |
| Bone | 424/730 (58) |
| Lung | 237/730 (32) |
| Lymph nodes | 212/730 (29) |
| Liver | 208/730 (28) |
| Abdominal site (other than liver) | 70/730 (10) |
| Brain | 68/730 (9) |
| Skin | 36/730 (5) |
| Number of patients in whom diagnosis of metastases was made by CA 15.3 increase, in relation to localisation of first distant metastases (several affected organs jointly are possible), n/N (%) | |
| Bone | 173/424 (41) |
| Lung | 70/237 (30) |
| Lymph nodes | 74/212 (35) |
| Liver | 94/208 (45) |
| Abdominal site (other than liver) | 23/70 (33) |
| Brain | 5/68 (7) |
| Skin | 3/36 (8) |
| CA 15.3 level at time of first diagnosis of metastases | |
| Mean value, kU/la | 70 ± 134 |
| CA 15.3 above the ULN (>30 kU/l), n/N (%) | 451/730 (62) |
| >50% Increase compared with lowest value measured between 6 months after treatment of EBC and moment of distant metastases, n/N (%) | 502/730 (69) |
| Without crossing the normal value (≤30 kU/l), n/N (%) | 81/502(16) |
| Crossing the normal value (>30 kU/l), n/N (%) | 421/502 (84) |
| Not showing an increase (≤50% increase compared with lowest value measured between 6 months after treatment of EBC and moment of distant metastases), n/N (%) | 205/730 (28) |
| Increase unknown, n/N (%) | 23/730 (3) |
| CA 15.3 increase above ULN (>30 kU/l) at the moment of diagnosis of metastatic disease, in relation to breast cancer subtype, n/N (%) | |
| Luminal A-like | 193/264 (73) |
| Luminal HER2-like | 38/52 (73) |
| Luminal B-like | 139/215 (65) |
| HER2-like | 25/56 (45) |
| Triple-negative | 56/143 (39) |
| Median interval between treatment of early breast cancer and diagnosis of metastases, in monthsb | 39 (37-42) |
| Diagnosis of metastases was triggered by history (n = 348) | 37 (33-42) |
| Diagnosis of metastases was triggered by CA 15.3 elevation (n = 269) | 44 (39-54) |
| Diagnosis of metastases was triggered by accidental finding (n = 55) | 33 (28-48) |
| Diagnosis of metastases was triggered by clinical examination (n = 27) | 37 (28-77) |
| Diagnosis of metastases was triggered by other laboratory changes (n = 31) | 26 (20-48) |
EBC, early breast cancer; HER2, human epidermal growth factor receptor 2; ULN, upper limit of normal.
a
Mean ± standard deviation.
b
95% Confidence interval.