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Invasive breast can...
Invasive breast cancer over four decades reveals persisting poor metastatic outcomes in treatment resistant subgroup - the "ATRESS" phenomenon
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- Jurrius, Patriek (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England;Guys & St Thomas NHS Fdn Trust, London SE1 9RT, England
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- Green, Thomas (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England
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- Garmo, Hans (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England
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- Young, Matthew (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England
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- Cariati, Massimiliano (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England;Guys & St Thomas NHS Fdn Trust, London SE1 9RT, England
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- Gillett, Cheryl (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England
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- Mera, Anca (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England
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- Harries, Mark (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England;Guys & St Thomas NHS Fdn Trust, London SE1 9RT, England
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- Grigoriadis, Anita (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England
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- Pinder, Sarah (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England;Guys & St Thomas NHS Fdn Trust, London SE1 9RT, England
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- Holmberg, Lars (author)
- Uppsala universitet,Endokrinkirurgi,Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England
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- Purushotham, Arnie (author)
- Kings Coll London, Sch Canc & Pharmaceut Sci, London SE1 9RT, England;Guys & St Thomas NHS Fdn Trust, London SE1 9RT, England
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(creator_code:org_t)
- CHURCHILL LIVINGSTONE, 2020
- 2020
- English.
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In: Breast. - : CHURCHILL LIVINGSTONE. - 0960-9776 .- 1532-3080. ; 50, s. 39-48
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Abstract
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- Background: Major advances in breast cancer treatment have led to a reducuction in mortality. However, there are still women who are not cured. We hypothesize there is a sub-group of women with treatment-resistant cancers causing early death.Methods: Between 1975 and 2006, 5392 women with invasive breast cancer underwent surgery at Guy's Hospital, London. Data on patient demographics, tumour characteristics, treatment regimens, local recurrence, secondary metastasis, and death were prospectively recorded. We considered four time periods (1975-1982, 1983-1990, 1991-1998, 1999-2006). Risks and time to event analysis were performed with Cox proportional hazards model and Kaplan-Meier estimation.Results: Unadjusted hazard ratios for developing metastasis and overall mortality relative to the 1975-1982 cohort decreased steadily to 0.23 and 0.63, respectively in 1999-2006. However, metastasis-free interval shortened, with the proportion of women developing metastasis <= 5 years increasing from 73.9% to 83.0%. Furthermore, median post-metastatic survival decreased from 1.49 years to 0.94 years. Applying our risk criteria identified the presence of +/- 200 patients in each cohort who developed metastasis early and died within a much shorter time frame.Conclusions: Advances in treatment have decreased the risk of metastasis and improved survival in women with invasive breast cancer over the last 40 years. Despite this, a subpopulation with shorter metastasis-free and post-metastatic survival who are unresponsive to available treatment remains. This may be due to the ATRESS phenomenon (adjuvant therapy-related shortening of survival) secondary to preselection inherent in adjuvant therapy, successful treatment of less malignant tumour cells and treatment-induced resistance in the remaining tumour clones.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- Breast cancer
- Post-metastatic survival
- ATRESS
- Treatment resistance
- Prognosis
Publication and Content Type
- ref (subject category)
- art (subject category)
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Breast
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- By the author/editor
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Jurrius, Patriek
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Green, Thomas
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Garmo, Hans
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Young, Matthew
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Cariati, Massimi ...
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Gillett, Cheryl
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Mera, Anca
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Harries, Mark
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Grigoriadis, Ani ...
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Pinder, Sarah
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Holmberg, Lars
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Purushotham, Arn ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
- Articles in the publication
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Breast
- By the university
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Uppsala University