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Breast Cancer With Synchronous Metastases: Trends in Survival During a 14-Year Period

From the Breast Cancer Unit, Institut Gustave Roussy, Villejuif; Department of Medicine, Centre Leon Berard, Lyon; and Department of Medicine, Centre Antoine Lacassagne, Nice, France

Address reprint requests to Fabrice Andre, MD, Breast Cancer Unit, Comite 050, Institut Gustave Roussy, 39 Rue C Desmoulins, 94805 Villejuif, France; e-mail: fandre{at}igr.fr

PURPOSE: Although new drugs were approved during the 1990s for the treatment of metastatic breast cancer, it is not clear whether their use has changed the outcome of patients in daily practice. This study sought to determine whether survival has improved over time for breast cancer patients who had metastases at diagnosis.

PATIENTS AND METHODS: A total of 724 patients have been treated in three French cancer centers for an initially metastatic breast cancer between 1987 and 2000; 343 were diagnosed between 1987 and 1993, and 381 were diagnosed between 1994 and 2000. Tumor characteristics, treatments, and outcomes of these patients were compared by ² test, log-rank test, and Cox regression analysis.

RESULTS: Characteristics were not different between the patients diagnosed from 1987 to 1993 and those diagnosed from 1994 to 2000. Ten percent of patients treated from 1987 to 1994 and 58% of patients treated from 1994 to 2000 have received either a taxane or a new aromatase inhibitor. The 3-year overall survival rates were 27% for patients treated from 1987 to 1993 and 44% for patients treated from 1994 to 2000 (P < .001). The treatment period (1994 to 2000 v 1987 to 1993) was a prognostic factor in multivariate analysis (relative risk, 0.6; P < .001).

CONCLUSION: The survival of breast cancer patients presenting with metastases at diagnosis has improved over time. This study strongly suggests that this improvement is related to treatment.

Supported by a Young Investigator Award from the American Society of Clinical Oncology (F.A.).

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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