Clinical Characteristics and Survival Analysis of Breast Cancer Molecular Subtypes with Hepatic Metastases

Background: The liver is one of the most common metastatic sites of breast cancer, hepatic metastasesdeveloping in 6%-25% of patients with breast cancer and being associated with a poor prognosis. The aim ofthis study was to analyze the survival and clinical characteristics of patients with hepatic metastases from breastcancer of different molecular subtypes and to investigate the prognostic and predictive factors that effect clinicaloutcome.
Methods: We retrospectively studied the charts of 104 patients with breast cancer hepatic metastasesdiagnosed at Sun Yat-sen University Cancer Center from December 1990 to June 2009. Subtypes were definedas luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) enriched, triple-negative (TN).Prognostic factor correlations with clinical features and treatment approaches were assessed at the diagnosis ofhepatic metastases.
Results: The median survival time was 16.0 months, and the one-, two- three-, four-, fiveyearsurvival rates were 63.5%, 31.7%, 15.6%, 10.8%, and 5.4%, respectively. Median survival periods afterhepatic metastases were 19.3 months (luminal A), 13.3 months (luminal B), 18.9 months (HER2-enriched), and16.1 months (TN, P=0.11). In multivariate analysis, a 2 year-interval from initial diagnosis to hepatic metastasis,treatment with endocrine therapy, and surgery were independent prognostic factors. Endocrine therapy couldimprove the survival of luminal subtypes (P=0.004) and was a favorable prognostic factor (median survival 23.4months vs. 13.8 months, respectively, P=0.011). Luminal A group of patients treated with endocrine therapy didsignificantly better than the Luminal A group of patients treated without endocrine therapy (median survivalof 48.9 vs. 13.8 months, P=0.003).
Conclusions: Breast cancer subtypes were not associated with survival afterhepatic metastases. Endocrine therapy was a significantly favorable treatment for patients with luminal subtype.