ArticleJournal of cancer research and clinical oncology2017
Improved systemic treatment for early breast cancer improves cure rates, modifies metastatic pattern and shortens post-metastatic survival: 35-year results from the Munich Cancer Registry.
Article in Journal of cancer research and clinical oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Chemotherapy-induced cognitive impairment in breast cancer survivors: A systematic review of studies from 2000 to 2021.Cancer reports (Hoboken, N.J.) · 2024Pooled it
- 4th ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4)†.Annals of oncology : official journal of the European Society for Medical Oncology · 2018Guideline
- Functional brain network alterations linked to cancer-related cognitive impairment in breast cancer patients.The oncologist · 2026Article
- Chemotherapy and the Extra-Tumor Immune Microenvironment: EXTRA-TIME.Cancer discovery · 2024Article
- Incidence of Nonkeratinocyte Skin Cancer After Breast Cancer Radiation Therapy.JAMA network open · 2024Article
- Impact of high dose radiotherapy for breast tumor in locoregionally uncontrolled stage IV breast cancer: a need for a risk-stratified approach.Radiation oncology (London, England) · 2023Review
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- Breast cancer: emerging principles of metastasis, adjuvant and neoadjuvant treatment from cancer registry data.Journal of cancer research and clinical oncology · 2023Review
- Radiotherapy of the Primary Disease for Synchronous Metastatic Cancer: A Systematic Review.Cancers · 2022Review
- Long term risk of distant metastasis in women with non-metastatic breast cancer and survival after metastasis detection: a population-based linked health records study.The Medical journal of Australia · 2022Article
- Article
- Soluble Neuropilin-1 is an independent marker of poor prognosis in early breast cancer.Journal of cancer research and clinical oncology · 2021Article
- Gaps in Care and Support for Patients With Advanced Breast Cancer: A Report From the Advanced Breast Cancer Global Alliance.JCO global oncology · 2021Article
- Breast cancer: are long-term and intermittent endocrine therapies equally effective?Journal of cancer research and clinical oncology · 2020Review
- Improved survival in metastatic breast cancer: results from a 20-year study involving 1033 women treated at a single comprehensive cancer center.Journal of cancer research and clinical oncology · 2020Article
- Invasive breast cancer over four decades reveals persisting poor metastatic outcomes in treatment resistant subgroup - the "ATRESS" phenomenon.Breast (Edinburgh, Scotland) · 2020Article
- NRSN2 promotes breast cancer metastasis by activating PI3K/AKT/mTOR and NF-κB signaling pathways.Oncology letters · 2020Article
- Does adjuvant therapy reduce postmetastatic survival?Annals of oncology : official journal of the European Society for Medical Oncology · 2019Article
- The effect of chemotherapy on subjective cognitive function in younger early-stage breast cancer survivors treated with chemotherapy compared to older patients.Breast cancer research and treatment · 2019Article
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Authors and funding
14 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSystemic therapies (ATHs) in early breast cancer have improved the survival of breast cancer (BC) patients in recent decades. The magnitude of the changes in overall, metastasis-free (MFS) and post-metastatic (PMS) survival and in the metastasis (MET) pattern will be described. PATIENT AND
methodsWe analysed 60,227 patients with a diagnosis of T-N-M0 BC between 1978 and 2013 and 11,983 patients with metastases (MET) in the Munich Cancer Registry. Patients will be divided into four time periods to identify relationships between BC and METs. Survival was estimated using Kaplan-Meier curves, and Cox proportional hazards models were used to explore the impact of the BC subtype and MET status on survival with the time periods as surrogate markers for ATH evolution.
resultsDuring the observation period, 5-year relative survival has improved from 80.3 to 93.6% with an adjusted hazard ratio of 0.54 (P < 0.0001). Successful implementation of ATH has changed the MET pattern. The percentage of liver and CNS METs has more than doubled, the rate of lung METs remains stable, and the rate of bone METs has been reduced by approximately 50%. MFS has been prolonged with a hazard ratio 0.75 (P < 0.0001), but PMS has declined (hazard ratio 1.36; P < 0.0001); however, effects of adjuvant and palliative treatments cannot be separated. These results do not contradict improvements in advanced BC and do not suggest alterations of MET tumour biology by ATH.
conclusionsOver the past three decades, ATHs have dramatically improved patient survival after BC diagnosis-most likely, by eradicating prevalent micro-METs; as a result, the MET pattern has changed. Eradicating only a portion of the first METs results in delaying the onset of subsequent MET, which leads to an apparently paradoxical effect: an extension of the MET-free interval and a reduction in PMS.
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