Examination of a paradox: recurrent metastatic breast cancer incidence decline without improved distant disease survival: 1990-2011

摘要

PurposeDistant relapse metastatic breast cancer (rMBC) incidence and survival are vital measures of breast cancer diagnosis and treatment progress over time.MethodsWe conducted a retrospective cohort study of stage I-III invasive breast cancer, 1990-2011, follow-up through 2016 [N=8292, rMBC=964 (12%)] at a community-based institution. Patient and tumor characteristics (treatment, distant recurrence, vital status) from BC registry data were evaluated. Survival analysis and Cox proportional hazards (HzR) with 95% confidence intervals (95% CI) were calculated using distant recurrence and distant disease-specific survival (DDSS) endpoints.ResultsBoth 5- and 10-year distant relapse (rMBC) declined over time from 1990-1998 to 2005-2011 [11% to 5%, 16% to 8% (p 1, or visceral metastases and stage III disease were associated with worse DDSS. DDSS did not improve over time.ConclusionrMBC incidence declined over time with decreased HER2-positive distant recurrence, a shift to more triple-negative BC and consistently poor distant disease survival.