Metastatic breast cancer is considered advanced cancer that has spread beyond the breast area to other parts of the body. Metastatic breast cancer is classified as stage IV. The bones, the lungs, and the brain are all places to where breast cancer can spread. Metastatic breast cancer is treatable, but generally not curable.
The study reviewed here looked at how long women survived after being diagnosed with metastatic breast cancer during two 10-year periods: 1985 to 1994 and 1995 to 2004. Between those two periods, a number of new medicines were developed to treat metastatic breast cancer so the researchers expected survival would improve. But the researchers found only a small increase in how long women lived after metastatic breast cancer diagnosis when they compared the later 10 years to the earlier 10 years. Between the same two 10-year periods survival time for metastatic colorectal cancer improved significantly.
Breast cancer hormone-receptor status affects treatment options, expected response to treatment, and overall prognosis. Hormone-receptor-negative breast cancer tends to be more aggressive and harder to treat than hormone-receptor-positive breast cancer. The researchers looked at survival information for hormone-receptor-positive and hormone-receptor-negative breast cancer during the two time periods.
For a diagnosis of metastatic hormone-receptor-positive breast cancer:
For a diagnosis of metastatic hormone-receptor-negative breast cancer:
If you or some one you love is dealing with metastatic breast cancer, these findings may be discouraging. Still, consider the following:
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WASHINGTON, Sept. 9 (MedPage Today) -- Survival in metastatic breast cancer has barely improved despite new therapeutic agents developed in the past decade, according to a retrospective review of clinical experience.
The median overall survival that tended to improve from 2.4 years during 1985 to 1994 to 3.1 years during 1995 to 2005 was not statistically significant (P=0.26), Sumanta K. Pal, M.D., of City of Hope Comprehensive Cancer Center in Duarte, Calif., reported at the 2008 ASCO Breast Cancer Symposium.
"In contrast to what we would have expected, there was no improvement in median overall survival between the decades of 1985 to 1994 and 1995 to 2005," said Dr. Pal.
Ongoing analyses of the City of Hope database have suggested a possible survival benefit in older patients with metastatic breast cancer, but the findings had not been confirmed, he added.
In contrast, new drugs over the past decade significantly improved overall survival in patients with metastatic colorectal cancer.
To examine trends in overall survival in metastatic breast cancer, Dr. Pal and colleagues retrospectively compared records on patients diagnosed from 1985 to 1994 and from 1995 to 2005. The latter period encompassed development of multiple new therapeutic agents, beginning with paclitaxel (Taxol) in 1994.
The review included a total of 358 cases of metastatic breast cancer, 199 diagnosed during the earlier time period and 159 during the later period. Comparing the two time periods, Dr. Pal found a survival hazard ratio of 1.14 in favor of the more recent time period, but the difference did not reach statistical significance (P=0.26).
Similarly, examination of data by hormone-receptor status (estrogen/progesterone positive versus negative) revealed no advantage for patients diagnosed during the period when new agents became available:
· ER+/PR+, 3.7 versus 3.8 years, HR0.97, P=0.59
· ER+/PR-, 2.5 versus 3.6 years, HR 1.11, P=0.83
· ER-/PR+, 1.5 versus 1.1 years, HR 0.72, P=0.78
· ER-/PR-, 1.9 versus 2.1 years, HR 1.05, P=0.87
During the same two time periods, median overall survival for patients with metastatic colorectal cancer increased from 1.2 years to 2.0 years, representing a statistically significant improvement (P<0.0001).
Dr. Pal and co-investigators reported no conflicts of interest.
Primary source: 2008 Breast Cancer Symposium Source reference: Pal SK, et al "Lack of survival benefit in metastatic breast cancer with newer chemotherapy agents: The City of Hope cancer experience" ASCO Breast 2008; Abstract 95.
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