University of Oulu

Karihtala P, Jääskeläinen A, Roininen N, et al, Prognostic factors in metastatic breast cancer: a prospective single-centre cohort study in a Finnish University Hospital, BMJ Open 2020;10:e038798. doi: 10.1136/bmjopen-2020-038798

Prognostic factors in metastatic breast cancer : a prospective single-centre cohort study in a Finnish University Hospital

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Author: Karihtala, Peeter1,2; Jääskeläinen, Anniina1; Roininen, Nelli1;
Organizations: 1Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Department of Oncology, Helsinki University Hospital Comprehensive Cancer Centre and University of Helsinki, Helsinki, Finland
3Department of Oncology, Tampere University Hospital, Cancer Center, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: BMJ, 2020
Publish Date: 2021-02-02


Objectives: Although novel early breast cancer prognostic factors are being continuously discovered, only rare factors predicting survival in metastatic breast cancer have been validated. The prognostic role of early breast cancer prognostic factors in metastatic disease also remains mostly unclear.

Design and setting: Prospective cohort study in a Finnish University Hospital.

Participants and outcomes: 594 women with early breast cancer were originally followed. Sixty-one of these patients developed distant metastases during the follow-up, and their primary breast cancer properties, such as tumour size, nodal status, oestrogen receptor (ER) and progesterone receptor expression, grade, proliferation rate, histopathological subtype and breast cancer subtype were analysed as potential prognostic factors for metastatic disease.

Results: In multivariate analysis, the presence of lymph node metastases at the time of early breast cancer surgery (HR, 2.17; 95% CI, 1.09–4.31; p=0.027) and ER status (negative vs positive, HR, 2.16; 95% CI, 1.14–4.10; p=0.018) were significant predictors of survival in metastatic disease.

Conclusions: These results confirm ER status as a primary prognostic factor in metastatic breast cancer. Furthermore, it also suggests that the presence of initial lymph node metastases could serve as a prognostic factor in recurrent breast cancer.

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Series: BMJ open
ISSN: 2044-6055
ISSN-E: 2044-6055
ISSN-L: 2044-6055
Volume: 10
Issue: 10
Article number: e038798
DOI: 10.1136/bmjopen-2020-038798
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
Copyright information: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.