Abstract P5-12-15: Hepatic-metastatsis pattern as a prognositc marker in metastatic breast cancer
Authors: Joung EK , Yang J-H , Lee J 
Published: May 2019

Background: Liver is the third most frequent site for breast cancer metastasis. Despite of relatively high frequency of liver metastasis and its poor prognosis (median survival between 14-16 months), little is known about clinical outcome and histologic features or molecular mechanisms. The aim of this study was to identify the prognostic factor of breast cancer with liver metastasis, including the hepatic metastasis pattern by imaging studies and pathologic feature.

Methods: We reviewed medical record of breast cancer patients with hepatic metastasis diagnosed between January 2003 and June 2017. We classified spreading pattern of liver metastases detected by computed-tomography scan as following three types: mass-forming (longitudinal diameter of new hepatic lesion &gt; 10mm, well-defined border for minimal 3 consecutive studies by CT scan), nodular (longitudinal diameter of any newly-noted hepatic lesion &lt; 10mm or 10mm, well-defined border for minimal 3 consecutive studies by CT scan) and infiltration pattern (to spread with ill-defined border for minimal 3 consecutive studies by CT scan). The overall survival (OS) was defined as the period from the date of initial diagnosis of liver metastasis to the date of patient's death or last follow-up.

Results : 115 of patients with initially metastatic breast cancer, and 42 patients with recurrent breast cancer after curative surgery were enrolled. 13% of total patients presented with only liver metastasis when they are initially diagnosed as the metastatic breast cancer. 19% of total patients presented with nodular or infiltration pattern. Median OS of the patients with mass-forming liver metastasis was 18.1 (95% CI: 6.8-29.5) months and in nodular distribution and diffuse infiltration pattern was 13.4 (95% CI: 78-18.9) months (p=0.001). To elucidate the role of hepatic-metastasis pattern as a prognostic marker, we performed the cox-regression analysis. The patients with nodular/infiltrative liver metastasis showed poorer prognosis (hazard ratio: 2.18, 95% CI: 1.23-3.86, p-value: 0.007) than patients with mass-forming liver metastases significantly. Other prognostic marker is the subtype of breast cancer. Either HER2-positive (hazard ratio: 2.88, 95% CI: 1.59-5.23, p-value: 0.001) or triple negative breast cancer patients (hazard ratio: 6.17, 95% CI : 2.57-14.8, p-value&lt;0.001) showed poorer prognosis than hormone-receptor positive subtype.

Conclusion: In the present study, the patients with mass-forming pattern of liver metastases hormone-receptor presentation showed favorable outcome in overall survival after liver metastases. Further studies are required for the different hepatic metastatic patterns and their mechanisms in metastatic breast cancer.

Citation Format: Joung EK, Yang J-H, Lee J. Hepatic-metastatsis pattern as a prognositc marker in metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-12-15.