Prognostic Factors in Breast Cancer Patients with Hepatic Metastases: Impact of Molecular Subtype and Local Hepatic Treatment

Abstract

Liver metastases usually develop in the terminal stage of breast cancer (BC), and often accompany with extrahepatic metastases. The prognosis of hepatic metastases (HM) in BC patient is poorer compared to bone and soft tissue metastases. In this study, we aimed to analyze some clinico-pathological prognostic factors in patients with HM. A total of 4300 follow-up records of breast cancer patients diagnosed and treated at Hacettepe University Cancer Institute between January 2000 and July 2015 were retrospectively analyzed. Total of 312 BC patients with HM were enrolled to study. Patients with HM at diagnosis and the patients who developed metastases during the follow-up were included. Total of 50 (16%) patients have HM as the first site of metastasis. While isolated HM were just seen in 36 (11%) patients, most of the patients had hepatic as well as bone metastases (n=148, 47%). Median interval from initial diagnosis to HM was 40.5 (5-262) months. Low grade (grade 1-2) tumors were associated with longer disease free interval to liver metastases by multivariate analysis. Overall survival after HM in whole group was 18 months. Multivariate analysis revealed statistically significant association between long survival and non-triple negative molecular subtype, lower stage disease at diagnosis and application of local hepatic treatment. Developments in systemic and targeted therapy, as well as local hepatic therapies may enhance outcomes of patient with hepatic metastases.